Bak M, Teglbjaerg P S
Institute of Pathology, Odense University Hospital, Denmark.
Cancer. 1989 Dec 15;64(12):2557-64. doi: 10.1002/1097-0142(19891215)64:12<2557::aid-cncr2820641225>3.0.co;2-g.
Pleomorphic (giant cell) carcinomas have been described in the lungs, thyroid, pancreas, and gallbladder. Two pleomorphic carcinomas of the small bowel and two of the large bowel are presented. On light microscopic study, the carcinomas were solid, without squamous or glandular differentiation. The tumors were composed of the following three cell types: gemistocytic (giant) cells, smaller polygonal cells, and spindle cells, with identical immunohistochemical reactions. A panel of monoclonal and polyclonal antibodies was applied. All tumors were found to coexpress keratin and vimentin. A positive reaction for neuron-specific enolase (NSE) was found in three tumors and a positive reaction for chromogranin was found in one tumor. On electron microscopic study, intracytoplasmic whorls of intermediate filaments were seen in the perinuclear area. Dense core "neurosecretory" granules were rarely seen. Intestinal pleomorphic carcinomas are histologically identical to pulmonary giant cell carcinomas. The prognosis is poor due to early tumor spread, with only a few months of postoperative survival. The pleomorphic carcinomas have some of the differentiation characteristics of carcinoid tumors and are best regarded as poorly differentiated variants of neuroendocrine carcinomas.
多形性（巨细胞）癌已在肺、甲状腺、胰腺和胆囊中被描述。本文报告了两例小肠多形性癌和两例大肠多形性癌。光镜下，这些癌呈实体状，无鳞状或腺性分化。肿瘤由以下三种细胞类型组成：肥胖型（巨）细胞、较小的多边形细胞和梭形细胞，具有相同的免疫组化反应。应用了一组单克隆和多克隆抗体。所有肿瘤均被发现同时表达细胞角蛋白和波形蛋白。在三个肿瘤中发现神经元特异性烯醇化酶（NSE）呈阳性反应，在一个肿瘤中发现嗜铬粒蛋白呈阳性反应。电镜下，在核周区域可见中间丝的胞质内漩涡。很少见到致密核心“神经分泌”颗粒。肠道多形性癌在组织学上与肺巨细胞癌相同。由于肿瘤早期扩散，预后较差，术后生存期仅几个月。多形性癌具有一些类癌肿瘤的分化特征，最好被视为神经内分泌癌的低分化变体。
