Li W H
Department of Pathology, General Hospital of PLA.
Zhonghua Bing Li Xue Za Zhi. 1990 Sep;19(3):182-4.
Twenty-two cases of neuroendocrine tumor comprising neurosecretory granules were identified ultrastructurally in 124 cases of resected pulmonary carcinoma. Among these, 10 cases of atypical carcinoid of the lung were examined by LM, EM and immunohistochemical staining for NSE. The diagnosis of atypical carcinoid is difficult by LM alone. Therefore light microscopic observation is required in combination with electron microscopic findings for obtaining an accurate diagnosis of atypical carcinoid of the lung. Based on the data observed in these 10 cases, the diagnostic criteria of atypical carcinoid of lung are as follows: Microscopically: Increased cellularity with organoid architecture and rosette formation. Patchy necrosis at the center of cancer nests. Pleomorphism and irregularity of nuclei with hyperchromatism. Presence of abundant mitotic figures. NSE is positive immunohistochemically. Ultrastructurally: Various amount of neurosecretory granules found in cancer cells. Rich organelles, such as mitochondria, RER and ribosomes found in cytoplasm. Presence of basal lamina and desmosomes.
在124例切除的肺癌病例中，超微结构鉴定出22例包含神经分泌颗粒的神经内分泌肿瘤。其中，对10例肺非典型类癌进行了光镜、电镜及NSE免疫组化染色检查。仅靠光镜诊断非典型类癌较为困难。因此，需要结合光镜观察和电镜结果才能准确诊断肺非典型类癌。基于这10例观察数据，肺非典型类癌的诊断标准如下：镜下：细胞增多，呈器官样结构及菊形团形成。癌巢中央有灶状坏死。细胞核多形性及大小不一，核染色质增粗。有大量核分裂象。免疫组化NSE阳性。超微结构：癌细胞内可见不同数量的神经分泌颗粒。细胞质内有丰富的细胞器，如线粒体、粗面内质网和核糖体。有基底膜和桥粒。
