Shintaku M, Hirano A, Llena J F
Bluestone Laboratory, Division of Neuropathology, Montefiore Medical Center, New York.
No Shinkei Geka. 1988 Jul;16(8):997-1003.
Glioblastoma multiforme with "adenoid formation" (Kepes) in the temporal lobe of a 70 year old man was presented. In addition to the classical features of glioblastoma multiforme, the tumor presented a pattern of anastomosing trabeculae of polygonal cells, mimicking epithelial tubules, in a myxoid stroma. On electron microscopic examination, the tumor cells were devoid of well-developed cytoplasmic processes. The cytoplasm of some tumor cells contained glycogen particles and lipid vacuoles in addition to usual organelles. The cell surface was partly covered by basal lamina associated with half desmosomes and had occasional filopodia-like cytoplasmic projections. A few tumor cells contained a dense intracytoplasmic accumulation of glial filaments. Intercellular junctional complexes were poorly developed. There was no evidence of differentiation of tumor cells toward ependymal cells or epithelial cells. These electron microscopic findings suggest that this tumor is predominantly composed of immature astrocytes. In spite of a superficial resemblance to adenocarcinoma on light microscopy, the tumor cells are devoid of the differentiating features of epithelial neoplasms, and their ultrastructure is essentially similar to that of glioblastoma multiforme.
报告了一名70岁男性颞叶多形性胶质母细胞瘤伴“腺样结构”(凯佩斯型)。除了多形性胶质母细胞瘤的典型特征外,肿瘤在黏液样基质中呈现出多边形细胞相互吻合的小梁结构,类似上皮小管。电子显微镜检查显示,肿瘤细胞缺乏发达的胞质突起。部分肿瘤细胞的细胞质除了含有常见细胞器外,还含有糖原颗粒和脂质空泡。细胞表面部分被与半桥粒相关的基膜覆盖,并有偶尔的丝状伪足样胞质突起。少数肿瘤细胞含有密集的胞质内胶质丝聚集。细胞间连接复合体发育不良。没有证据表明肿瘤细胞向室管膜细胞或上皮细胞分化。这些电子显微镜检查结果表明,该肿瘤主要由未成熟的星形胶质细胞组成。尽管在光学显微镜下表面上与腺癌相似,但肿瘤细胞缺乏上皮性肿瘤的分化特征,其超微结构与多形性胶质母细胞瘤基本相似。