Kũttner K, Katenkamp D, Stiller D
Arch Otorhinolaryngol. 1977 Feb 15;214(4):331-8.
Four juvenile angiofibromas were examined with the electron microscope. Preceding the operation a hormonal therapy with stilbestrol disphosphate (Cytonal, Honvan) was carried out in the cases. The therapeutical effect after application of this drug is clearly correlated to especial changes in histology and cytology. The changes comprise reactions of the vascular component and of the stromal fibroblasts. Endothelial cells and pericytes show a markedly diminished cellular activity, a proliferation of vascular wall cells is not to be proved. The stromal fibroblasts may predominantly be classified as fibroblasts with histiocyte-like features, at which the organelle equipment speaks for a high activity of their metabolism. Furthermore an increased number of myofibroblasts and smooth muscle-like elements are encountered in the stroma. The striking diminution of lesion size and the reduction of disposition to bleeding from the beginning of the hormone therapy is suggested as a direct consequence of cellular contraction. Additionally alterations of synthesis of collagen fibers and ground substance by fibroblasts with histiocyte-like features contribute to a further gradual decrease of the growths.
对4例青少年血管纤维瘤进行了电子显微镜检查。术前对这些病例采用二磷酸己烯雌酚（赛托那、洪凡）进行激素治疗。应用该药物后的治疗效果与组织学和细胞学的特殊变化明显相关。这些变化包括血管成分和基质成纤维细胞的反应。内皮细胞和周细胞显示细胞活性明显降低，未证实血管壁细胞有增殖。基质成纤维细胞主要可归类为具有组织细胞样特征的成纤维细胞，其细胞器装备表明其代谢活性较高。此外，在基质中还发现肌成纤维细胞和平滑肌样成分数量增加。激素治疗开始时病变大小显著减小和出血倾向降低，提示这是细胞收缩的直接结果。此外，具有组织细胞样特征的成纤维细胞对胶原纤维和基质合成的改变有助于肿瘤进一步逐渐缩小。
