Cresson D H, Reddick R L
Department of Pathology, School of Medicine, Chapel Hill, North Carolina 27514.
J Surg Oncol. 1987 Dec;36(4):268-74. doi: 10.1002/jso.2930360411.
The clinicopathologic and ultrastructural features of a sarcomatoid carcinoma of the pancreas presenting initially as gastric carcinoma are described. By light microscopy, the tumor contained cellular patterns similar to those present in tumors of mesenchymal origin. Spindle cell areas arranged in a storiform pattern were present. Ultrastructurally, bundles of cytoplasmic microfilaments were present in the cell cytoplasm and were similar in distribution to those found on fine structural examination in tumors of mesenchymal origin. Rows of desmosomes were found between cells supporting an epithelial origin for this tumor. Following initial therapy, metastatic tumor produced polypoid lesions in the small intestine resulting in recurrent small bowel intussuceptions. Our findings indicate that sarcomatoid carcinoma of the pancreas, by both light and ultrastructural examination, is a heterogenous tumor at the cellular level and may be a cause of repeated intussuception when intraluminal compromise occurs.
本文描述了一例最初表现为胃癌的胰腺肉瘤样癌的临床病理及超微结构特征。光镜下，肿瘤具有与间叶组织来源肿瘤相似的细胞形态。可见呈车轮状排列的梭形细胞区域。超微结构上，细胞质内可见成束的微丝，其分布与间叶组织来源肿瘤的精细结构检查所见相似。细胞间发现有一排排桥粒，支持该肿瘤的上皮来源。初始治疗后，转移瘤在小肠内形成息肉样病变，导致小肠反复套叠。我们的研究结果表明，通过光镜和超微结构检查，胰腺肉瘤样癌在细胞水平上是一种异质性肿瘤，当发生管腔内压迫时可能是反复套叠的原因。
