Lymphovascular invasion (LVI or lymphovascular space invasion) is the
invasion
An invasion is a military offensive in which large numbers of combatants of one geopolitical entity aggressively enter territory owned by another such entity, generally with the objective of either: conquering; liberating or re-establishing con ...
of a
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
to the
blood vessel
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away ...
s and/or
lymphatics.
Terminology
Lymph: A clear or white fluid that travels through vessels, moves within tissues and work to keep all the parts of the body clean.
Vascular: The body's network of blood vessels.
When cancer spreads to lymph and vascular system, it is thus termed as ''Lymphovascular Invasion.''
Pathology
Lymphovascular invasion, especially in
carcinoma
Carcinoma is a malignancy that develops from epithelial cells. Specifically, a carcinoma is a cancer that begins in a tissue that lines the inner or outer surfaces of the body, and that arises from cells originating in the endodermal, mesodermal ...
s, usually precedes spread to the lymph nodes that drain the tissue in which the tumour arose. Conversely, cancers with lymph node spread (known as a
lymph node metastases
A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that includ ...
), usually have lymphovascular invasion. Lymph node metastases usually precede secondary tumours, i.e. distant
metastases
Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then, ...
.
The absence of LVI in the context of proven lymph node metastasis is usually thought to be due to
sampling error.
Prognostic significance
The predictive value and prevalence of lymphovascular invasion is strongly dependent on the type of cancer. In other words, LVI in one type of cancer may be much less important than LVI in another type of cancer.
Generally speaking, it is associated with lymph node metastases
which themselves are predictive of a poorer
prognosis
Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stabl ...
.
In the context of (
histologically) proven lymph node metastases, LVI may have less prognostic significance or no prognostic significance.
Breast cancer
Whether LVI is a significant prognostic factor in breast cancer is widely debated, and there is no clear consensus.
Urothelial carcinoma
In
urothelial carcinoma, LVI is an independent predictor of a poorer prognosis that has more predictive power than
tumour stage
Cancer staging is the process of determining the extent to which a cancer has developed by growing and spreading. Contemporary practice is to assign a number from I to IV to a cancer, with I being an isolated cancer and IV being a cancer that ha ...
.
Colorectal cancer
In sporadic
colorectal carcinoma
Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel ...
, LVI of a poorer prognosis.
See also
*
Perineural invasion
*
Malignancy
References
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Cancer pathology
Oncology