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. 2009;9(1-2):182-8.
doi: 10.1159/000178890. Epub 2008 Dec 13.

Is Serous Cystadenoma of the Pancreas a Model of Clear-Cell-Associated Angiogenesis and Tumorigenesis?

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Is Serous Cystadenoma of the Pancreas a Model of Clear-Cell-Associated Angiogenesis and Tumorigenesis?

Duangpen Thirabanjasak et al. Pancreatology. .
Free PMC article

Abstract

Background: Similar to the other von Hippel-Lindau (VHL)-related tumors such as renal cell carcinomas and capillary hemangioblastomas, serous cystadenomas (SCAs) of the pancreas are also characterized by clear cells. Over the years, we have also noticed that the tumor epithelium shows a prominent capillary network.

Methods: Eighteen cases of SCA were reviewed histologically, and immunohistochemical analysis was performed for CD31 and vascular endothelial growth factor (VEGF) as well as the molecules implicated in clear-cell tumorigenesis: GLUT-1, hypoxia-inducible factor-1 (HIF-1alpha), and carbonic anhydrase IX (CA IX).

Results: There was an extensively rich capillary network that appears almost intraepithelially in all cases of SCA, which was confirmed by CD31 stain that showed, on average, 26 capillaries per every 100 epithelial cells. VEGF expression was identified in 10/18 cases. Among the clear-cell tumorigenesis markers, CA IX was detected in all cases, GLUT-1 and HIF-1alpha in most cases.

Conclusion: As in other VHL-related clear-cell tumors, there is a prominent capillary network immediately adjacent to the epithelium of SCA, confirming that the clear-cell- angiogenesis association is also valid for this tumor type. Molecules implicated in clear-cell tumorigenesis are also consistently expressed in SCA. This may have biologic and therapeutic implications, especially considering the rapidly evolving drugs against these pathways. More importantly, SCA may also serve as a model of clear-cell-associated angiogenesis and tumorigenesis, and the information gained from this tumor type may also be applicable to other clear-cell tumors.

Figures

Fig. 1
Fig. 1
Well circumscribed, bosselated round lesion with polycystic and honey comb-like cut surface, showing numerous cysts in various size.
Fig. 2
Fig. 2
The low cuboidal tumor cells with clear cytoplasm are intimately admixed with the prominent capillary network (fig. 3).
Fig. 3
Fig. 3
CD31 discloses both the abundance of capillaries and their preferential distribution around the epithelial cells.
Fig. 4
Fig. 4
VEGF stain shows strong and consistent positivity in both cell membrane and cytoplasm. This was seen in 10/18 cases.
Fig. 5
Fig. 5
GLUT-1 was expressed diffusely in almost all cases. The staining accentuates the membranes, but cytoplasmic labeling is also present.
Fig. 6
Fig. 6
CA IX, a good marker of clear cell tumors, was expressed in all cases, with mostly membranous labeling.
Fig. 7
Fig. 7
Diagram shows the model of clear-cell tumorigenesis and angiogenesis.

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