Vascular and cellular events in post-mastectomy seroma: An immunohistochemical study

This study aimed to describe the vascular and cellular histopathological changes that occurred in post-mastectomy seroma in an animal model. Unilateral mastectomies were conducted on 45 female albino rabbits. On day seven, the skin flap and the underlying tissues of the mastectomy regions were dissected and processed for histopathological examination using immunohistochemical staining of the T- and B-lymphocytes and macrophages (CD3, CD20, and CD68 respectively), and the vascular endothelia. The post-mastectomy regions in the seroma group showed a large number of inflammatory cells and newly formed blood vessels that lost the integrity of their endothelial cell linings, as revealed by the von Willebrand factor staining, as well the basement membrane, as revealed by the histochemical stain. The post-mastectomy seroma beds showed many CD3 and CD20+ve lymphocytes and CD68+ve macrophages. These macrophages were producing angiogenic factors, resulting in the persistent and continuous formation of new blood vessels. These new blood vessels were defective and represented an underlying cause of seroma formation.

Graphical abstractFigure optionsDownload full-size imageDownload as PowerPoint slideHighlights► Immunohistochemical study of postmastectomy seroma showed large number of inflammatory cells. ► These cells included; CD3, CD20, and CD68+ve cells. ► Seroma bed showed blood vessels that lost the endothelial cells integrity. ► These defective blood vessels is an underling cause of seroma formation.