Willemer S, Rüschoff J, Adler G, Schwerk W B, Arnold R
Abteilung für Gastroenterologie, Philipps-Universität Marburg.
Z Gastroenterol. 1990 Oct;28(10):565-70.
Ultrasonic-guided fine-needle-biopsies of primary pancreatic tumours or liver metastasis were performed in 13 patients with neuroendocrine tumours of the gastrointestinal tract (5 carcinoids, 3 gastrinoma, 1 PPoma, 1 calcitoninoma, 1 insulinoma, and 2 non-functional tumours). Specimens obtained were examined on the light- and electronmicroscopic level. In all cases ultrastructural examination sufficiently revealed the correct diagnosis, due to the presence of cytoplasmic neuroendocrine granules within the tumour cells. Additionally performed immunocytochemical investigations at the ultrastructural level enabled the discrimination of gastrinomas, insulinomas, and PPomas. In contrast, light-microscopic examination was less sensitive for tumour classification. It is concluded that ultrastructural investigation of fine needle biopsies represents a valuable method to sufficiently discriminate neuroendocrine neoplasms.
对13例胃肠道神经内分泌肿瘤患者(5例类癌、3例胃泌素瘤、1例胰多肽瘤、1例降钙素瘤、1例胰岛素瘤和2例无功能性肿瘤)进行了原发性胰腺肿瘤或肝转移灶的超声引导下细针穿刺活检。对获取的标本进行了光镜和电镜检查。在所有病例中,由于肿瘤细胞内存在细胞质神经内分泌颗粒,超微结构检查足以明确正确诊断。此外,在超微结构水平上进行的免疫细胞化学研究能够区分胃泌素瘤、胰岛素瘤和胰多肽瘤。相比之下,光镜检查对肿瘤分类的敏感性较低。结论是,细针穿刺活检的超微结构研究是充分鉴别神经内分泌肿瘤的一种有价值的方法。