Kraevskiĭ N A, Belous T A, Litvinova L V
Arkh Patol. 1982;44(4):9-18.
Electron microscopic examinations of pleomorphic adenoma tissue showed epithelial and myoepithelial cell elements to take part in morphogenesis of both epithelial and "mesenchymal" zones. The epithelial component of pleomorphic adenoma is represented by cells showing signs of structural-functional differentiation of the squamous epithelium,, epithelium of terminal secretory parts of the salivary gland, and myoepithelial cells. The "mesenchymal" component is also represented by myoepithelial and epithelial cells. Differences in the structure of the epithelial and "mesenchymal" components are due to the pattern of arrangement and the functional status of the cells rather than to the set of the cell forms. A slow growth of the tumor and the marked functional activity of myoepithelial cells result in the accumulation of the substance of basal membranes released into the intercellular space, separation of the cells and degenerative changes in them. The results of ultrastructural examinations confirm the theory of the epithelial genesis of salivary gland pleomorphic adenoma. In this connection it sould be acknowledged that the term "mixed tumor" does not relate the essence of this neoplasia because the point at issue is a tumor of epithelial nature, whereas the term "pleomorphic adenoma" recommended by the WHO is more acceptable and emphasized the epithelial origin and heterogeneity of the cell composition and structures of the tumor.
多形性腺瘤组织的电子显微镜检查显示,上皮细胞和肌上皮细胞成分参与了上皮区和“间充质”区的形态发生。多形性腺瘤的上皮成分由显示鳞状上皮、唾液腺终末分泌部上皮和肌上皮细胞结构-功能分化迹象的细胞组成。“间充质”成分也由肌上皮细胞和上皮细胞组成。上皮成分和“间充质”成分结构上的差异是由于细胞的排列方式和功能状态,而非细胞形式的组合。肿瘤生长缓慢以及肌上皮细胞显著的功能活性导致释放到细胞间隙的基底膜物质积累、细胞分离及其退行性改变。超微结构检查结果证实了唾液腺多形性腺瘤上皮起源的理论。就此而言,应该承认“混合瘤”这一术语并不能反映这种肿瘤的本质,因为问题的关键是一种上皮性肿瘤,而世界卫生组织推荐的“多形性腺瘤”这一术语更合适,它强调了肿瘤的上皮起源以及细胞组成和结构的异质性。