Hruban R H, Traganos F, Reuter V E, Huvos A G
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York.
Am J Pathol. 1990 Aug;137(2):435-47.
The authors studied four chordomas with malignant spindle cell components (SCs) and 12 conventional chordomas (CCs) by DNA flow cytometry using paraffin-embedded tissue. In addition, immunohistochemical stains for a variety of epithelial and mesenchymal markers were performed. The four SCs contained areas histologically identical to conventional chordomas, as well as a high-grade malignant spindle cell component. All four (100%) SCs had an aneuploid-multiploid DNA content. Of interest, the conventional chordoma areas in these tumors had DNA contents different from those containing the high-grade malignant spindle cells. In contrast, only three (27%) of the 11 conventional chordomas with analyzable histograms had an aneuploid-multiploid DNA content. Immunohistochemical studies performed on the four SCs showed the high-grade malignant spindle cells to stain strongly for vimentin and weakly for cytokeratin, S-100 protein, and epithelial membrane antigen (EMA), whereas the areas of conventional chordoma in these same neoplasms stained moderately for vimentin and S-100 protein, and strongly for cytokeratin and EMA. In two cases, the staining for EMA and cytokeratin highlighted a gradual transition between the areas of conventional chordoma and the spindle cell areas. The immunohistochemical staining pattern of the 12 conventional chordomas was similar to that seen in the conventional chordoma components of the four chordomas with malignant spindle cell components. These results suggest that: 1) aneuploidy is more common in SCs than in CCs, and 2) some SCs are multipotential neoplasms in which the neoplastic cells are capable of differentiation along both epithelial and mesenchymal pathways.
作者使用石蜡包埋组织，通过DNA流式细胞术研究了4例伴有恶性梭形细胞成分（SCs）的脊索瘤和12例传统脊索瘤（CCs）。此外，还进行了多种上皮和间充质标志物的免疫组织化学染色。这4例SCs包含组织学上与传统脊索瘤相同的区域，以及高级别恶性梭形细胞成分。所有4例（100%）SCs均具有非整倍体-多倍体DNA含量。有趣的是，这些肿瘤中的传统脊索瘤区域的DNA含量与含有高级别恶性梭形细胞的区域不同。相比之下，11例具有可分析直方图的传统脊索瘤中只有3例（27%）具有非整倍体-多倍体DNA含量。对这4例SCs进行的免疫组织化学研究显示，高级别恶性梭形细胞波形蛋白染色强，细胞角蛋白、S-100蛋白和上皮膜抗原（EMA）染色弱，而这些肿瘤中相同肿瘤内的传统脊索瘤区域波形蛋白和S-100蛋白染色中等，细胞角蛋白和EMA染色强。在2例病例中，EMA和细胞角蛋白染色突出了传统脊索瘤区域与梭形细胞区域之间的逐渐过渡。12例传统脊索瘤的免疫组织化学染色模式与4例伴有恶性梭形细胞成分的脊索瘤的传统脊索瘤成分相似。这些结果表明：1）非整倍体在SCs中比在CCs中更常见，2）一些SCs是多潜能肿瘤，其中肿瘤细胞能够沿上皮和间充质途径分化。
