Ishikawa Y, Asuwa N, Ishii T, Masuda S, Kiguchi H
Department of Pathology, Hachioji Medical Center, Tokyo Medical College, Japan.
Pathol Int. 1994 Jun;44(6):466-74. doi: 10.1111/j.1440-1827.1994.tb01712.x.
A case of basaloid-squamous carcinoma of the esophagus in an 83 year old man is reported. The esophageal tumor showed a fungating growth at the junction of the middle and lower esophagus and was composed microscopically of submucosal multiple nests with solid and cribriform-like patterns accompanied with a small focus of squamous cell carcinoma adjacent to the overlying esophageal epithelium. The structural features closely resembled those of basaloid-squamous carcinoma. The submucosal tumor cells were immunohistochemically positive for epithelial membrane antigen, wide spectral keratin, alpha actin and S-100 protein. By electron microscopy, the tumor cells had microvilli, desmosomes and bundles of myofilaments, and replicated basement membranes were frequently observed adjacent to the nests. The positive immunoreaction of S-100 protein and alpha actin and the existence of bundles of myofilaments indicated that the present tumor did not correspond well with basaloid-squamous carcinoma. In addition, there was no evidence of true glandular lumina in the tumor nests, a finding which was inconsistent with that of adenoid cystic carcinoma. From the immunoreactivity of S-100 protein and ultrastructural features, it was considered that the present submucosal tumor had originated from undifferentiated pluripotential primitive cells, which differentiated to myoepithelial cells.
报告了一例83岁男性食管基底样鳞状细胞癌。食管肿瘤在下段食管交界处呈蕈伞状生长，显微镜下由黏膜下多个实性和筛状样结构的巢状组织构成，伴有一小灶鳞状细胞癌，紧邻覆盖的食管上皮。其结构特征与基底样鳞状细胞癌极为相似。黏膜下肿瘤细胞上皮膜抗原、广谱角蛋白、α肌动蛋白和S-100蛋白免疫组化呈阳性。电镜下，肿瘤细胞有微绒毛、桥粒和肌丝束，且在巢状组织附近常可见复制的基底膜。S-100蛋白和α肌动蛋白的阳性免疫反应以及肌丝束的存在表明，目前的肿瘤与基底样鳞状细胞癌不太相符。此外，肿瘤巢内未见真正的腺腔，这一发现与腺样囊性癌不符。根据S-100蛋白的免疫反应性和超微结构特征，认为目前的黏膜下肿瘤起源于未分化的多潜能原始细胞，这些细胞分化为肌上皮细胞。
