Tsuneyoshi M
Gan To Kagaku Ryoho. 1987 May;14(5 Pt 2):1577-83.
The differential diagnosis of malignant soft tissue tumors constitutes a major problem in surgical pathology. A distinction among sarcomas is sometimes difficult, but this is a situation in which histologic examination of representative tissue will give a diagnosis in the majority of cases. Electron microscopy sometimes contributes to the proper diagnosis of sarcomas. For electron microscopy, fresh samples from 110 cases of sarcoma filed at the Department of Pathology, Faculty of Medicine, Kyushu University, were examined. The distinguishing ultrastructural appearance of the following tumors are discussed: Spindle cell sarcomas (leiomyosarcoma 10 cases, malignant Schwannoma 5, fibrosarcoma 5, monophasic synovial sarcoma 7). Round cell sarcomas (rhabdomyosarcoma 10 cases, extraskeletal Ewing's sarcoma 1, malignant neuroepithelioma 1, malignant rhabdoid tumor of soft parts 3, monophasic synovial sarcoma 9). Pleomorphic sarcomas (malignant fibrous histiocytoma 24 cases, pleomorphic liposarcoma 1). Myxoid sarcomas (myxoid malignant fibrous histiocytoma 8 cases, myxoid liposarcoma 8, extraskeletal myxoid chondrosarcoma 4). Sarcomas with a specific pattern. Using electron microscopy, general analysis of cellular morphology and detection of specific structures are helpful for evaluating these sarcomas. Nevertheless, poorly differentiated sarcomas may still pose a diagnostic dilemma, since their specific features are poorly represented.
恶性软组织肿瘤的鉴别诊断是外科病理学中的一个主要问题。有时区分肉瘤很困难,但在大多数情况下,对代表性组织进行组织学检查能得出诊断结果。电子显微镜检查有时有助于肉瘤的正确诊断。对九州大学医学部病理学系存档的110例肉瘤新鲜样本进行了电子显微镜检查。讨论了以下肿瘤独特的超微结构表现:梭形细胞肉瘤(平滑肌肉瘤10例、恶性施万瘤5例、纤维肉瘤5例、单相滑膜肉瘤7例)。圆形细胞肉瘤(横纹肌肉瘤10例、骨外尤文肉瘤1例、恶性神经上皮瘤1例、软组织恶性横纹肌样瘤3例、单相滑膜肉瘤9例)。多形性肉瘤(恶性纤维组织细胞瘤24例、多形性脂肪肉瘤1例)。黏液样肉瘤(黏液样恶性纤维组织细胞瘤8例、黏液样脂肪肉瘤8例、骨外黏液样软骨肉瘤4例)。具有特定模式的肉瘤。利用电子显微镜,对细胞形态进行综合分析以及检测特定结构有助于评估这些肉瘤。然而,低分化肉瘤可能仍然会带来诊断难题,因为它们的特征表现不明显。