Lymphatic/vascular invasion & nodal disease
- Best assessed around periphery of tumour
- Difficulty distinguishing from shrinkage artefact in section - do not overdiagnose!
- Lymphatics tend to accompany small veins arteries and nerves - if seen improves confidence in diagnosis
- Tumour in vessels tends to be 'stuck' to the sides and may be accompanied by red cells
- An independent prognostic factor so do not diagnose just because the nodes are positive!!
A cuff of lymphatic invasion around a small vein in a vascular bundle