Costa M J, Thomas W, Majmudar B, Hewan-Lowe K
Department of Pathology, Grady Memorial Hospital, Emory University, School of Medicine, Atlanta, Georgia 30335-3801.
Ultrastruct Pathol. 1992 Jul-Aug;16(4):429-38. doi: 10.3109/01913129209057828.
The ultrastructural and immunohistochemical findings are reported in two ovarian myxomas, one of which was also associated with a sclerosing stromal tumor of the same ovary. Both neoplasms showed a myxoid, moderately cellular proliferation of spindle and stellate cells interspersed with areas of fibrosis and hemorrhage as well as delicate vascular spaces. Ultrastructurally, stellate neoplastic cells with irregular nuclei and occasional nucleoli were embedded in a mucinous and loose collagen matrix. Their cytoplasm showed abundant intracytoplasmic thin filaments that rarely condensed into poorly formed dense bodies. These thin filaments correlated with immunoreactivity for muscle-specific actin and vimentin. The neoplastic cells showed no immunoreactivity with antibodies to desmin, S-100 protein, cytokeratin AE1:AE3, factor VIII-related protein, or placental alkaline phosphatase. These ultrastructural and immunohistochemical findings are consistent with myofibroblastic differentiation. These ancillary studies exclude important, clinically more aggressive differential considerations such as myxoid rhabdomyosarcoma, myxoid liposarcoma, myxoid neural tumors, mucinous adenocarcinoma showing pseudomyxomatous change, and myxoid-appearing endodermal sinus (yolk sac) tumor.
本文报道了两例卵巢黏液瘤的超微结构和免疫组化结果，其中一例还与同一卵巢的硬化性间质瘤相关。两种肿瘤均表现为黏液样、中等细胞密度的梭形和星状细胞增生，其间散在纤维化和出血区域以及细小的血管间隙。超微结构上，核不规则且偶见核仁的星状肿瘤细胞包埋于黏液样和疏松的胶原基质中。其胞质内可见丰富的细丝，很少聚集成形态不佳的致密小体。这些细丝与肌特异性肌动蛋白和波形蛋白的免疫反应性相关。肿瘤细胞对结蛋白、S-100蛋白、细胞角蛋白AE1:AE3、因子VIII相关蛋白或胎盘碱性磷酸酶抗体均无免疫反应性。这些超微结构和免疫组化结果与肌成纤维细胞分化一致。这些辅助检查排除了一些重要的、临床侵袭性更强的鉴别诊断，如黏液样横纹肌肉瘤、黏液样脂肪肉瘤、黏液样神经肿瘤、表现为假黏液瘤样改变的黏液腺癌以及呈黏液样外观的内胚窦（卵黄囊）瘤。
