Yazawa T, Ogata T, Kamma H, Shibagaki T, Iijima T, Horiguchi H
Department of Pathology, Tsukuba University Hospital, Ibaraki, Japan.
Virchows Arch A Pathol Anat Histopathol. 1991;419(6):513-8. doi: 10.1007/BF01650681.
In order to investigate the probable embryonic nature of pulmonary blastoma, immunohistochemical studies were performed using stage-specific embryonic antigens (Ley, Lex, sialyl Lex-i) in case of pulmonary blastoma with a very wide spectrum of morphological features. The tumour presented a topographic transition from primitive blastic and embryonic areas to more differentiated areas showing diverse differentiation. Blastic areas composed of extremely immature cells were found in most peripheral parts of the tumour. Inside the blastic areas there were "embryonic" areas which morphologically resembled human embryo lungs in the pseudoglandular and canalicular stages. Most central parts of the tumour showed more differentiated features including chondrosarcomatous, leiomyosarcomatous and rhabdomyosarcomatous elements and the common type of adenocarcinomatous element. Electron microscopic observation suggested the blastic and embryonic nature of these immature cell elements. Ley was expressed in the blastic and pseudoglandular areas. Lex was expressed in the canalicular areas. These antigens were not expressed in the more differentiated areas. The topographic gradient in the tumour of morphology and antigen expression from the peripheral blastic areas to the central more differentiated areas suggests that the primitive cells gradually differentiated into more mature cells of various directions as the tumour grew in size.
为了研究肺母细胞瘤可能的胚胎性质，我们对具有非常广泛形态学特征的肺母细胞瘤病例使用阶段特异性胚胎抗原（Ley、Lex、唾液酸化Lex-i）进行了免疫组织化学研究。肿瘤呈现出从原始母细胞和胚胎区域到显示不同分化的更分化区域的地形学转变。在肿瘤的最外周部分发现了由极不成熟细胞组成的母细胞区域。在母细胞区域内有“胚胎”区域，其形态在假腺泡期和小管期类似于人类胚胎肺。肿瘤的最中央部分表现出更分化的特征，包括软骨肉瘤、平滑肌肉瘤和横纹肌肉瘤成分以及常见类型的腺癌成分。电子显微镜观察提示这些未成熟细胞成分具有母细胞和胚胎性质。Ley在母细胞和假腺泡区域表达。Lex在小管区域表达。这些抗原在更分化的区域不表达。肿瘤中从外周母细胞区域到中央更分化区域的形态学和抗原表达的地形学梯度表明，随着肿瘤体积的增大，原始细胞逐渐分化为各种方向的更成熟细胞。
