Vascular Architecture of Renal Adenocarcinoma

A characteristic vascular architecture of renal adenocarcinoma distinct from that of other tumors was revealed by histological and angiological analyses. In this tumor cancer cell alveoli were directly coated with vascular endothelial cells, and interalveolar spaces constituted complicated sinusoidal blood spaces, which were different in shape from anastomosing blood vessels. Immediately beneath the tumor capsule, the blood spaces were found to receive blood from the capsular arteries, and the sinusoids drained into the veins in a pattern similar to that of hepatic sinusoids and central veins. Such a vascular structure was found also in certain endocrine organs including the adrenal gland. The particular vascular structure of renal adenocarcinoma was interpreted as predisposing exfoliation of cancer cells into the blood spaces and blood-brone metastasis. In angiographical treatments, ‘pooling’, ‘puddling’ and other unusual findings were observed on account of pooling or stagnation of contrast medium in complicated blood spaces. Expanded blood spaces, which might develop after tumor necrosis, exhibited the pictures of ‘laking’ or ‘a-v fistula’.