Radiogenic Lymphangiogenesis in the Skin

[patoco]

Radiogenic Lymphangiogenesis in the Skin

Am J Pathol. 2007 May 31

Jackowski S, Janusch M, Fiedler E, Marsch WC, Ulbrich EJ, Gaisbauer G,
Dunst J, Kerjaschki D, Helmbold P.

From the Departments of Dermatology,* Gynaecology, and Radiotherapy, Martin Luther University Halle-Wittenberg, Halle, Germany; the Department of Radiotherapy, University of Lübeck, Lübeck, Germany; the Institute of Pathology, Medical University of Vienna, Vienna, Austria;
and the Department of Dermatology, University of Heidelberg,
Heidelberg, Germany.

The time course of microvascular changes in the environment of
irradiated tumors was studied in a standardized human protocol. Eighty
skin biopsies from 40 patients with previously treated primary breast
cancer were taken from irradiated skin and corresponding contralateral
unirradiated control areas 2 to 8 weeks, 11 to 14 months, or 17+
months after radiotherapy (skin equivalent dose 30 to 40 Gy). Twenty-
two biopsies of 11 melanoma patients who had undergone lymph node
dissection were used for unirradiated control. We found an increase of
total podoplanin(+) lymphatic microvessel density resulting mainly
from a duplication of the density of smallest lymphatic vessels
(diameter <10 microm) in the samples taken 1 year after radiation. Our
findings implicate radiogenic lymphangiogenesis during the 1st year
after therapy. The numbers of CD68(+) and vascular endothelial growth
factor-C(+) cells were highly elevated in irradiated skin in the
samples taken 2 to 8 weeks after radiotherapy. Thus, our results
indicate that vascular endothelial growth factor-C expression by
invading macrophages could be a pathogenetic route of induction of
radiogenic lymphangiogenesis.

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Pat O'Connor
Lymphedema People
http://www.lymphedemapeople.com