Angioarchitecture of pulmonary malignancies in humans

Abstract

Selective bronchial arteriography in 46 patients with lung cancer was performed to scrutinize the vasculature of pulmonary malignancies in vivo. This, together with further studies on 17 surgical materials by magnified and microscopic methods, has revealed many interesting characteristics of vasculature of pulmonary neoplasms. A gross classification of these vascular patterns of “vascular” and “avascular” was attempted from the results of clinical angiography. The existence of those two vascular patterns was able to be confirmed by pathologic angiographies on resected specimens. Bronchial arteriography in vivo revealed either marked or moderate development of blood vessels in 28 out of 46 patients, and this study also showed a relatively well-developed vasculature in adenocarcinoma rather than in epidermoid. Microscopic examination was done on the same materials in which angiographies were achieved, and demonstrated that tumor vessels proved sinusoidal blood canals consisting of a thin-layered endothelial wall. Electron microscopically, endothelial cells of tumor vessels had fenestrations, diaphragms, and pores elsewhere which are observed in the fenestrated type capillary in inflammation. These characteristics of the intraneoplastic vasculatures may suggest a manifestation of necessity for a good amount of blood flow for rapid growth of malignancies and rapid exchange of metabolic properties through the vessel wall.