Kimura N, Tezuka F, Ono I, Ishioka K, Sasano N
Department of Pathology, Tohoku University School of Medicine, Sendai, Japan.
Arch Pathol Lab Med. 1989 Oct;113(10):1159-65.
Four cases of esophageal polypoid tumors composed of squamous cell carcinoma and spindle cell sarcomatous components were investigated. Squamous cell carcinoma was consistently present in the base of the polypoid lesions in all four cases and was also intermingled with spindle-shaped sarcomatous cells in two cases. Metastases in the lymph nodes were observed in two cases: one was squamous cell carcinoma with a sarcomatous component and the other consisted of a pure sarcomatous component. All tumors involved at least the muscularis mucosae. In the sarcomatous region, the tumor was composed of highly anaplastic cells with or without forming interlacing fascicles. Pleomorphism was marked and bizarre giant cell forms were frequent. Mitoses were frequently present. Immunohistochemical study revealed that the anaplastic cells in the sarcomatous component in all cases were immunoreactive to desmin, muscle actin, vimentin, and alpha 1-antichymotrypsin, but were negative for cytokeratin, even in the metastatic tumors of the lymph nodes. The immunohistochemical results favor myogenic differentiation of the anaplastic cells, and these tumors were considered to be true carcinosarcomas composed of squamous cell carcinoma and leiomyosarcoma.
对4例由鳞状细胞癌和梭形细胞肉瘤成分组成的食管息肉样肿瘤进行了研究。在所有4例中，鳞状细胞癌始终存在于息肉样病变的基底，在2例中还与梭形肉瘤细胞混合存在。2例观察到淋巴结转移：1例为伴有肉瘤成分的鳞状细胞癌，另1例为纯肉瘤成分。所有肿瘤至少累及黏膜肌层。在肉瘤区域，肿瘤由高度间变的细胞组成，有或无交错束状结构。多形性明显，怪异的巨细胞形式常见。有丝分裂频繁出现。免疫组织化学研究显示，所有病例中肉瘤成分的间变细胞对结蛋白、肌动蛋白、波形蛋白和α1抗胰凝乳蛋白酶呈免疫反应，但对细胞角蛋白呈阴性，即使在淋巴结转移瘤中也是如此。免疫组织化学结果支持间变细胞的肌源性分化，这些肿瘤被认为是由鳞状细胞癌和平滑肌肉瘤组成的真正的癌肉瘤。
