Ooi A, Nakanishi I, Itoh T, Ueda H, Mai M
Department of Surgery, Kanazawa University, Japan.
Pathol Res Pract. 1991 Mar;187(2-3):220-5. doi: 10.1016/S0344-0338(11)80775-2.
A distinct morphological variant of a diffuse type adenocarcinoma of the stomach with Paneth cell differentiation is reported. The tumor was a Borrmann's Type III carcinoma measuring 6.0 x 5.5 cm at the body along the greater curvature. It was composed of Paneth cell- and endocrine cell differentiated cancer cells in addition to tubular and poorly differentiated adenocarcinoma cells. The Paneth cell differentiation was characterized histologically by cytoplasmic distinct coarse eosinophilic granules stained red with periodic acid-Schiff and Masson trichrome reagents and reddish brown with phosphotungstic acid hematoxylin, and electron microscopically by lysozyme in cytoplasmic electron dense granules. In addition, electron microscopy revealed acid mucin globules and various intermediate forms between Paneth granules and the mucin globules which might be regarded as abortive forms of Paneth granules presumably resulting from defective incorporation of lysozyme-positive mucosubstances into acid mucin. Endocrine differentiated cancer cells consisted of serotonin-, peptide YY-, and glucagon/glicentin-positive cells. The various cell phenotypes found in the present tumor could be explained on the basis of intestinal differentiation of gastric cancer.
报告了一种具有潘氏细胞分化的弥漫型胃腺癌的独特形态学变异型。该肿瘤为Borrmann III型癌，位于胃体大弯侧，大小为6.0×5.5 cm。除管状和低分化腺癌细胞外，还由潘氏细胞和内分泌细胞分化的癌细胞组成。潘氏细胞分化的组织学特征为：胞质内有明显粗大的嗜酸性颗粒，用高碘酸-希夫试剂和Masson三色试剂染色呈红色，用磷钨酸苏木精染色呈红棕色；电镜下可见溶菌酶存在于胞质电子致密颗粒中。此外，电镜还显示酸性黏液球以及潘氏颗粒与黏液球之间的各种中间形式，这些中间形式可能被视为潘氏颗粒的发育不全形式，推测是由于溶菌酶阳性黏膜物质掺入酸性黏液存在缺陷所致。内分泌分化的癌细胞由血清素、肽YY和胰高血糖素/胰高血糖素原阳性细胞组成。本肿瘤中发现的各种细胞表型可基于胃癌的肠化生来解释。
