Vance R P, Geisinger K R, Randall M B, Marshall R B
Department of Pathology, Wake Forest University Medical Center, Winston-Salem, North Carolina.
Am J Clin Pathol. 1988 Oct;90(4):397-411. doi: 10.1093/ajcp/90.4.397.
Immature neural tissue pathobiology in teratomas may have important implications for clinical prognosis, nervous system embryology, and neurological oncology. However, immunohistochemical and ultrastructural examinations of these neoplasms have been scarce. The authors examined immunohistochemically the immature neural elements in nine immature teratomas. Using modified peroxidase-antiperoxidase (PAP) immunoperoxidase (IP) techniques, they evaluated the immunoreactivity to glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), neurofilament (NF), chromogranin (CG), and vimentin (VM). All nine teratomas were immunoreactive for both GFAP and NSE, one was reactive for NF, and five (56%) were immunoreactive for vimentin. All cases were nonreactive for chromogranin. In addition, ultrastructural examination (electron microscopic [EM]) was performed on eight of these tumors. By EM examination, both astrocytes and oligodendroglia were identified in varying stages of development. Astrocytes often displayed abundant intermediate filaments. However, primitive undifferentiated cells were also found. Neuronal differentiation included long cell processes with tubules and filaments, vesicles, rare dense-core granules, and synapses. Ependymal differentiation (cilia, microvilli, prominent junctions) was observed in two cases. Pigmented retinal epithelium was seen in one tumor. No ambiguous (hybrid) cells were identified. Cellular interactions usually resembled the relationships found in normal adult brain tissue.
畸胎瘤中未成熟神经组织的病理生物学可能对临床预后、神经系统胚胎学和神经肿瘤学具有重要意义。然而，对这些肿瘤进行免疫组织化学和超微结构检查的研究很少。作者对9例未成熟畸胎瘤中的未成熟神经成分进行了免疫组织化学检查。他们使用改良的过氧化物酶-抗过氧化物酶（PAP）免疫过氧化物酶（IP）技术，评估了胶质纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）、神经丝（NF）、嗜铬粒蛋白（CG）和波形蛋白（VM）的免疫反应性。所有9例畸胎瘤对GFAP和NSE均呈免疫反应性，1例对NF呈反应性，5例（56%）对波形蛋白呈免疫反应性。所有病例对嗜铬粒蛋白均无反应。此外，对其中8例肿瘤进行了超微结构检查（电子显微镜[EM]）。通过EM检查，在不同发育阶段均鉴定出星形胶质细胞和少突胶质细胞。星形胶质细胞常显示丰富的中间丝。然而，也发现了原始未分化细胞。神经元分化包括带有微管和细丝、囊泡、罕见的致密核心颗粒和突触的长细胞突起。在2例中观察到室管膜分化（纤毛、微绒毛、明显的连接）。在1例肿瘤中可见色素性视网膜上皮。未发现模糊（混合）细胞。细胞间相互作用通常类似于正常成人大脑组织中的关系。
