Kuwashima Y, Nakamura T, Sawabe M, Kanno J, Kitagawa M, Matsubara O, Kasuga T
Department of Pathology, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
Acta Pathol Jpn. 1991 Dec;41(12):905-10. doi: 10.1111/j.1440-1827.1991.tb01637.x.
A case of poorly differentiated adenocarcinoma of the stomach with unique histological features is reported: in addition to characteristic adenocarcinoma cells, a large number of tumor cells contained bright eosinophilic and argentaffin granules in their cytoplasm. On routine histologic examination, the latter cells closely resembled the endocrine cells present in the normal human gastrointestinal tract, although the granules were distributed throughout the cytoplasm and did not show any polarity, which is usually subnuclear in normal endocrine cells. Immunohistochemical studies demonstrated positive staining for lysozyme, CEA, gastrin and HCG. Electron microscopic examination revealed cytoplasmic neurosecretory granules, and some tumor cells were found to contain both secretory granules and mucinous material within the same cytoplasm. These neoplastic endocrine cells presumably originated from primitive digestive system elements capable of differentiating towards both endocrine and mucus-secreting varieties.
除了特征性的腺癌细胞外,大量肿瘤细胞的细胞质中含有明亮的嗜酸性和嗜银颗粒。在常规组织学检查中,后一种细胞与正常人胃肠道中的内分泌细胞非常相似,尽管颗粒分布于整个细胞质中,且不显示任何极性,而正常内分泌细胞的颗粒通常位于核下。免疫组织化学研究显示溶菌酶、癌胚抗原、胃泌素和人绒毛膜促性腺激素染色呈阳性。电子显微镜检查发现细胞质中有神经分泌颗粒,并且一些肿瘤细胞在同一细胞质中同时含有分泌颗粒和粘液物质。这些肿瘤性内分泌细胞可能起源于能够向内分泌和粘液分泌类型分化的原始消化系统成分。