Different growth patterns of primary and metastatic tumors are a reflection of different interactions of the cancer cells with the surrounding tissue structures. The observation of nonangiogenic growth patterns in human carcinomas challenges the hypothesis that tumor growth is always dependent on angiogenesis. It would be more correct to say that neoplastic growth depends on an adequate blood supply. If this can be obtained from a vascular bed that already exists, the tumor can grow without the formation of new blood vessels.
Alveolar growth pattern: Nonangiogenic growth pattern described in primary nonsmall-cell lung cancer and in pulmonary metastases; tumor cells fill the alveoli and exploit the interalveolar capillaries for their blood supply.
Fibrotic focus: Focus of exaggerated reactive tumor stroma formation in the center of a carcinoma consisting of collagen, a variable number of fibroblasts, blood vessels, and inflammatory cells; practical histopatholog-ical surrogate marker of hypoxia-driven angiogenesis in breast cancer.
Nonangiogenic growth: Tumor growth without induction of angio-genesis in which tumor cells obtain adequate blood supply by exploiting a preexisting vascular bed.
Replacement growth pattern: Nonangiogenic growth pattern described in liver metastases; tumor cells replace the hepatocytes in the liver plates and exploit the sinusoidal blood vessels for their blood supply.
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Cecile G. Colpaert is a pathologist working in a teaching hospital. Her main interest is breast cancer and the application of research findings from the field of tumor biology in diagnostic pathology practice.
Peter B. Vermeulen is a diagnostic pathologist doing translational breast cancer research mainly focused on angiogenesis and tumor-stroma interactions.
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