Konrad E A, Meister P, Hübner G
Cancer. 1982 Mar 1;49(5):898-907. doi: 10.1002/1097-0142(19820301)49:5<898::aid-cncr2820490513>3.0.co;2-g.
Five extracardiac rhabdomyomas were studied by light and electron microscopy: two of the adult type, two of the fetal type, and one of the female genital tract type. The three types can be distinguished histologically and ultrastructurally. Adult type rhabdomyomas are encapsulated and reveal histologically closely packed, large tumor cells with granular or vacuolated cytoplasm and only scant stroma. Electron microscopically, myofibrils are haphazardly arranged with rodlike Z-band material. Sometimes a sarcomeric arrangement of myofibrils is seen. The tumor cells are packed with mitochondria bearing lamellar inclusions. Fetal type rhabdomyomas contain a mixture of muscle cells in different stages of differentiations; the amount of stroma is increased. The myofilaments are usually disorganized and in only a few cells is rodlike Z-band material found. The cytoplasm reveals few mitochondria. In the rhabdomyoma of the female genital tract, the tumor cells are large and resemble more mature muscle fibers; the stroma is abundant and the myofilaments are usually arranged in an orderly fashion. Generally, the prognosis for rhabdomyomas is good. Metastases are not known. Two of the five rhabdomyomas studied recurred. One rhabdomyoma was found at autopsy. Embryonal rhabdomyosarcoma must be considered in differential diagnosis particularly for fetal type rhabdomyoma.
对5例心脏外横纹肌瘤进行了光镜和电镜研究：2例为成人型，2例为胎儿型，1例为女性生殖道型。这三种类型在组织学和超微结构上可以区分。成人型横纹肌瘤有包膜，组织学上可见紧密排列的大肿瘤细胞，细胞质呈颗粒状或空泡状，间质稀少。电镜下，肌原纤维排列紊乱，有杆状Z带物质。有时可见肌原纤维呈肌节状排列。肿瘤细胞内充满带有板层状包涵体的线粒体。胎儿型横纹肌瘤含有不同分化阶段的肌细胞混合物；间质增多。肌丝通常排列紊乱，仅在少数细胞中发现杆状Z带物质。细胞质中可见少量线粒体。在女性生殖道横纹肌瘤中，肿瘤细胞较大，更类似于成熟的肌纤维；间质丰富，肌丝通常排列有序。一般来说，横纹肌瘤的预后良好。未见转移。所研究的5例横纹肌瘤中有2例复发。1例横纹肌瘤在尸检时发现。在鉴别诊断中必须考虑胚胎性横纹肌肉瘤，尤其是胎儿型横纹肌瘤。
