[Role of angiogenesis in the pathogenesis of cholesteatoma in adults]

The aim of the study was to compare the vessels among cholesteatoma perimatrix, cholesterol granuloma and skin sections and to investigate the localization and expression of CD34 antigen. 14 cholesteatoma specimens were used in this study. Comparative material consisted of skin specimens taken from the retroauricular area during the ear surgical procedure and 4 specimens of cholesterol granuloma collected from children. Monoclonal mouse antibodies against human CD34 were used for immunohistochemistry which was performed using a standard labelled avidin-biotin technique. Automatic imaging analyzing system was used for counting. The skin specimens showed presence of small blood vessels in the subepithelial area and around the glands. The mean number of the vessels in these specimens was 5.44/mm2 and the mean relative proportion of total vessel area/total area of connective tissue: 4.9+/-2.0%. In the specimens of cholesterol granuloma the mean number of vessels was 34.06+/-21.2/mm2 and the mean relative proportion of total vessel area/total area of connective tissue: 22.1+/-3.1%. In cholesteatoma perimatrix, the mean number of microvessels calculated within 1 mm2 of the subepithelial connective tissue was significantly higher (22.79+/-11.2/mm2) and the mean relative proportion of total vessel area/total area of the perimatrix was 12.1+/-2.8%. Angiogenesis appear in the subepithelial connective tissue of cholesteatoma (perimatrix). The process of angiogenesis makes possible and sustains the migration of keratinocytes into the cavity of the middle ear, their increased proliferation and the expansion of cholesteatoma. Therefore, angiogenesis is considered to be one of the destructive features of this disease.