Gyorkey F, Min K W, Krisko I, Gyorkey P
Hum Pathol. 1975 Jul;6(4):421-41. doi: 10.1016/s0046-8177(75)80061-x.
Ultrastructural features of neoplastic cells can provide clues for correct diagnosis when light microscopy fails. Secretory granules are characteristic in the following tumors: mucin granules in poorly differentiated adenocarcinomas, zymogen granules in acinic cell carcinomas, lysosomal granules in prostatic carcinomas, melanin granules in malignant melanoma, carcinoid, islet cell tumors, pheochromocytoma, and neuroblastoma granules in the corresponding neoplasms. Among cytoplasmic organelles, rough surfaced endoplasmic reticulum characterizes adrenocortical, ovarian, and hepatocellular carcinomas and plasmacytomas. Tonofibrils are characteristic of squamous cell carcinomas. Glycogen deposits distinguish Ewing's sarcoma from lymphoreticular neoplasms. Intercellular relationships and membrane specialization are important features in the differential diagnosis of various undifferentiated tumors. The frequent resolution of difficult diagnostic problems by electron microscopy outweighs the disadvantages of this technique, such as the expense and time required.
当光学显微镜无法做出正确诊断时，肿瘤细胞的超微结构特征可为诊断提供线索。分泌颗粒在以下肿瘤中具有特征性：低分化腺癌中的黏液颗粒、腺泡细胞癌中的酶原颗粒、前列腺癌中的溶酶体颗粒、恶性黑色素瘤中的黑色素颗粒、类癌、胰岛细胞瘤、嗜铬细胞瘤以及相应肿瘤中的神经母细胞瘤颗粒。在细胞质细胞器中，粗面内质网是肾上腺皮质癌、卵巢癌、肝细胞癌和浆细胞瘤的特征。张力原纤维是鳞状细胞癌的特征。糖原沉积可将尤因肉瘤与淋巴网状肿瘤区分开来。细胞间关系和膜特化是各种未分化肿瘤鉴别诊断中的重要特征。电子显微镜能够频繁解决疑难诊断问题，其优势超过了该技术的缺点，如费用和所需时间。
