Park Sung-Hye, Kim Min-Kyung, Kim Hanseong, Song Byung Joo, Chi Je G
Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea.
J Korean Med Sci. 2004 Apr;19(2):234-44. doi: 10.3346/jkms.2004.19.2.234.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract (GIT). Although interstitial cells of Cajal has been suggested as origin of this tumor, the cytological and ultrastructural features of GISTs are heterogeneous and unclear. A total 10 cases of normal gastrointestinal tissue (control), 13 GISTs of the stomach (8), small intestine (3), mesocolon (1) and liver (1), and 2 gastrointestinal autonomic nervous tumor (GANT) of small intestine were ultrastructurally studied. Normal interstitial cells of Cajal (ICC) were abundantly present around the myenteric plexuses or individually scattered through the wall of GIT. ICC was characterized by slender cytoplasmic processes, well-developed endoplasmic reticulum (ER), mitochondria, Golgi apparatus, caveolae and intermediate filaments. The GISTs and GANTs had overlapping ultrastructures. The most common and important ultrastructural features of GISTs were rich villous cytoplasmic processes, dispersed intermediate filaments and abundant SER, and those of GANTs were neurosecretory granules and skenoid fibers. Compared with ICC, the GISTs and GANTs had remarkably reduced caveolae and gap junctions. Our study suggested that ultrastructural analysis gives much information to investigate lineage differentiation of neoplastic cells and make a differential diagnosis of these tumors from other mesenchymal tumors and between GISTs and GANTs.
胃肠道间质瘤（GISTs）是胃肠道（GIT）中最常见的间充质肿瘤。尽管有人提出 Cajal 间质细胞是这种肿瘤的起源，但 GISTs 的细胞学和超微结构特征是异质性的且不明确。对总共 10 例正常胃肠道组织（对照）、13 例 GISTs（胃 8 例、小肠 3 例、结肠系膜 1 例、肝脏 1 例）以及 2 例小肠胃肠道自主神经肿瘤（GANT）进行了超微结构研究。正常的 Cajal 间质细胞（ICC）大量存在于肌间神经丛周围或单独散布于 GIT 壁中。ICC 的特征是具有细长的细胞质突起、发达的内质网（ER）、线粒体、高尔基体、小窝和中间丝。GISTs 和 GANTs 具有重叠的超微结构。GISTs 最常见且重要的超微结构特征是丰富的绒毛状细胞质突起、分散的中间丝和丰富的滑面内质网，而 GANTs 的特征是神经分泌颗粒和类肌纤维。与 ICC 相比，GISTs 和 GANTs 的小窝和缝隙连接明显减少。我们的研究表明，超微结构分析为研究肿瘤细胞的谱系分化以及对这些肿瘤与其他间充质肿瘤之间以及 GISTs 和 GANTs 之间进行鉴别诊断提供了很多信息。
