Lawrence J B, Mazur M T
Hum Pathol. 1982 Oct;13(10):916-24. doi: 10.1016/s0046-8177(82)80052-x.
Histologic, histochemical, and ultrastructural features of eight adenoid cystic carcinomas arising at diverse sites were compared in order to determine diagnostic values and to investigate histogenetic mechanisms. These tumors originated in the salivary glands, breast, uterine cervix, and tracheobronchial tree. By light microscopy each tumor was seen to have morphologic features of adenoid cystic carcinoma, yet only five of the eight cases showed differential staining for the two mucin types, stromal and epithelial, which are reportedly present in these tumors. In contrast, every case showed a set of fine structural features which, in aggregate, are specific for adenoid cystic carcinoma. These features include pseudocysts, intercellular spaces, basal lamina, and true glandular lumens. The most prominent feature is the pseudocyst, which mimics a glandular lumen by light microscopy but is actually a rounded extracellular space containing basal lamina. Ultrastructurally, the variation in composition of the extracellular compartments, including pseudocysts and true lumens, appears to explain the lack of uniformity in the histochemical staining. The tumors also contained cytoplasmic microfilaments in parallel bundles, consistent with myofilaments. The presence of these filaments combined with basal lamina suggests myoepithelial differentiation, yet it is not known whether these tumors truly originate from myoepithelium or show differentiation toward myoepithelium as a part of the neoplastic process. Regardless of their histogenesis, this study shows that true adenoid cystic carcinomas do arise in different organs. Knowledge of the specific ultrastructural features of adenoid cystic carcinomas can be useful in classifying these tumors in some cases.
为了确定诊断价值并研究组织发生机制，对8例发生于不同部位的腺样囊性癌的组织学、组织化学和超微结构特征进行了比较。这些肿瘤起源于唾液腺、乳腺、子宫颈和气管支气管树。通过光学显微镜观察，每个肿瘤均具有腺样囊性癌的形态学特征，但8例中只有5例显示出两种黏液类型（基质型和上皮型）的差异染色，据报道这些肿瘤中存在这两种黏液类型。相比之下，每例均显示出一组精细结构特征，总体而言，这些特征是腺样囊性癌所特有的。这些特征包括假囊肿、细胞间隙、基膜和真正的腺腔。最突出的特征是假囊肿，在光学显微镜下它类似于腺腔，但实际上是一个含有基膜的圆形细胞外间隙。在超微结构上，细胞外间隙（包括假囊肿和真正的管腔）组成的变化似乎解释了组织化学染色缺乏一致性的原因。肿瘤还含有平行排列的细胞质微丝，与肌丝一致。这些微丝与基膜的存在提示肌上皮分化，但尚不清楚这些肿瘤是否真正起源于肌上皮，或者在肿瘤形成过程中是否表现出向肌上皮的分化。无论其组织发生如何，本研究表明真正的腺样囊性癌确实可发生于不同器官。了解腺样囊性癌的特定超微结构特征在某些情况下有助于对这些肿瘤进行分类。
