Nabarra B, Manganella G, Savino W
Inserm 25, UA 122 CNRS, Hôpital Necker, Paris, France.
Pathol Res Pract. 1989 Aug;185(2):257-63; discussion 264-6. doi: 10.1016/S0344-0338(89)80267-5.
This study of a particular case of tumor posed and resolved problems of differential diagnosis between an undifferentiated tumor and a thymoma by using electron microscopy in association with immunocytochemical methods. The first step was the distinction between an epithelial and a mesenchymal tumor, which was done by electron microscopy and immunofluorescence observation with anti-keratin antibody. The second step, a new approach to this problem, was the distinction between an epithelial tumor of thymic origin and another tumor located in the mediastinal lodge. A clear distinction was made by observation in immunofluorescence using anti-thymulin monoclonal antibody. This double approach permits differential diagnosis, excludes neoplasms of germ-cell origin, malignant lymphomas and leukemias, as well as mesenchymal tumors, and affirms the thymic origin of the tumor observed. A second type of cell observed in this tumor with a peculiar aspect, different from all types of epithelial cells observed in normal thymus, is discussed.
本项针对特定肿瘤病例的研究，通过将电子显微镜与免疫细胞化学方法相结合，提出并解决了未分化肿瘤与胸腺瘤之间的鉴别诊断问题。第一步是通过电子显微镜以及使用抗角蛋白抗体的免疫荧光观察，区分上皮性肿瘤和间叶性肿瘤。第二步是针对该问题的一种新方法，即区分胸腺起源的上皮性肿瘤与位于纵隔腔的其他肿瘤。通过使用抗胸腺素单克隆抗体进行免疫荧光观察得以明确区分。这种双重方法能够进行鉴别诊断，排除生殖细胞起源的肿瘤、恶性淋巴瘤和白血病以及间叶性肿瘤，并确定所观察到的肿瘤的胸腺起源。文中还讨论了在该肿瘤中观察到的第二种细胞类型，其形态特殊，与正常胸腺中观察到的所有类型上皮细胞均不同。
