Mucosal lymphatic vessels of the esophagus distant from the cancer margin: morphometrical analysis using 27 surgically removed specimens of squamous cell carcinoma located in the upper or middle thoracic esophagus.

Purpose: To clarify the configuration of the esophageal mucosal lymphatics distant from cancer using D2-40 immunohistochemistry.

Methods: D2-40 immunohistochemistry for human lymphatic epithelium was performed at sites about 10 cm anal from the pathologically examined margin of upper or mid- thoracic squamous cell carcinoma (27 patients). We measured the entire length of mucosal lymphatic vessels within a x10 objective field (1.2 mm along the muscularis mucosae).

Results: The present morphometrical study demonstrated significant individual differences in the amount of mucosal lymphatic vessels, within a range of more than 10-fold (8.4 mm-0.8 mm within an objective field). However, the difference in length of the mucosal lymphatic epithelium did not correlate with either N-factor, T-factor including cancer depth or prognosis.

Conclusion: A higher density of pre-existing mucosal lymphatic vessels may not always be correlated with larger numbers of nodal metastases. Lymphatic proliferation or dilation induced by cancer seems to occur irrespective of whether pre-existing vessels are rich or sparse.