Tsuneyoshi M, Yokoyama R, Hashimoto H, Enjoji M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Acta Pathol Jpn. 1989 Sep;39(9):573-81. doi: 10.1111/j.1440-1827.1989.tb02486.x.
We carried out a histologic, immunohistochemical and ultrastructural study of 19 tumors, previously classified as Ewing's sarcoma of the bone (ESB). The tumors were categorized histologically into four groups according to the presence or absence and the distribution of Homer-Wright rosettes, together with the immunohistochemical and ultrastructural features: 1) neuroectodermal tumor of bone (NTB) with diffusely dispersed rosettes (4 cases), 2) conventional ESB totally lacking the rosettes (9 cases), 3) intermediate-type tumor with characteristics of both NTB and ESB (4 cases), and 4) spindle cell-type tumor with focal rosettes (2 cases). Ultrastructurally, NTB contained neurotubules and neurosecretory granules, whereas ESB consisted of only undifferentiated cells. Immunoreactivity with antineural antibodies, such as Leu-7, and those against synaptophysin, NSE, neurofilament, and chromogranin, was detected in the majority of NTB, in intermediate- and spindle cell-type tumors and in two of the nine cases of ESB. In view of these findings, we propose that use of the term "neuroectodermal tumor of the bone" should be restricted to tumors with an extensive distribution of rosettes, and that those without unequivocal rosettes should be classified as ESB, although ESB may be the most undifferentiated form of NTB and some overlap may occur between the two tumor types.
我们对19例先前被归类为骨尤文肉瘤（ESB）的肿瘤进行了组织学、免疫组织化学和超微结构研究。根据霍纳-赖特玫瑰花结的有无及分布情况，结合免疫组织化学和超微结构特征，将这些肿瘤组织学上分为四组：1）具有弥漫性散在玫瑰花结的骨神经外胚层肿瘤（NTB）（4例），2）完全缺乏玫瑰花结的经典ESB（9例），3）具有NTB和ESB两者特征的中间型肿瘤（4例），4）具有局灶性玫瑰花结的梭形细胞型肿瘤（2例）。超微结构上，NTB含有神经微管和神经分泌颗粒，而ESB仅由未分化细胞组成。在大多数NTB、中间型和梭形细胞型肿瘤以及9例ESB中的2例中检测到与抗神经抗体（如Leu-7）以及抗突触素、NSE、神经丝和嗜铬粒蛋白的免疫反应性。鉴于这些发现，我们建议“骨神经外胚层肿瘤”这一术语应仅限于具有广泛玫瑰花结分布的肿瘤，而那些没有明确玫瑰花结的肿瘤应归类为ESB，尽管ESB可能是NTB最未分化的形式，且两种肿瘤类型之间可能存在一些重叠。
