Balercia G, Bhan A K, Dickersin G R
Department of Anatomy, University of Verona, Italy.
Ultrastruct Pathol. 1995 Jul-Aug;19(4):249-63. doi: 10.3109/01913129509064228.
The histogenesis of sarcomatoid carcinoma has been an intriguing topic for pathologists for many years, and considerable evidence has accumulated in the fields of tissue culture, electron microscopy, and immunohistochemistry to support the concept that the sarcomatous cells derive by way of "divergent differentiation" (metaplasia) from the carcinomatous elements. We have studied a group of 10 cases of these tumors from various organs, using detailed ultrastructural analysis as well as light microscopic and immunohistochemical correlation. We found that there is an ultrastructural spectrum of differentiation from epithelial to mesenchymal type features and that the malignant spindle cells may be purely epithelial (3 cases), purely mesenchymal (3 cases), or a mixture of both (4 cases). Furthermore, individual cells may show biphasia, having desmosomes and tonofibrils as well as well developed rough endoplasmic reticulum and filaments with dense bodies. Electron microscopic and immunohistochemical results do not always correlate, illustrating the prudence of using several keratin antibodies, including wide-spectrum ones, and of performing electron microscopic examination on these tumors.
多年来，肉瘤样癌的组织发生一直是病理学家们感兴趣的话题，在组织培养、电子显微镜和免疫组织化学领域已经积累了大量证据，支持肉瘤细胞通过“分化异常”（化生）从癌成分衍生而来的概念。我们对一组来自不同器官的10例此类肿瘤进行了研究，采用了详细的超微结构分析以及光镜和免疫组织化学相关性分析。我们发现存在从上皮型到间充质型特征的超微结构分化谱，恶性梭形细胞可能纯粹是上皮性的（3例）、纯粹是间充质性的（3例）或两者的混合（4例）。此外，单个细胞可能表现出双相性，具有桥粒和张力原纤维，以及发育良好的粗面内质网和带有致密小体的细丝。电子显微镜和免疫组织化学结果并不总是相关的，这说明了使用多种角蛋白抗体（包括广谱抗体）以及对这些肿瘤进行电子显微镜检查的谨慎性。
