Mentzel T, Wadden C, Fletcher C D
Department of Histopathology, St Thomas's Hospital (UMDS), London, UK.
Histopathology. 1994 Mar;24(3):223-31. doi: 10.1111/j.1365-2559.1994.tb00514.x.
Nine smooth muscle tumours, arising at a variety of sites and showing granular cell change of their cytoplasm, have been studied morphologically and immunohistochemically. The age of the patients ranged from 6 to 78 years (median 42 years); seven patients were female. Two tumours each arose in the dermis or subcutaneous tissue while the other five cases were situated in deeper soft tissue. Three of the lesions arose in the lower limbs, two in the pelvis and one each in the regions of the elbow, shoulder, breast and buttock. Follow-up in eight patients was available and revealed local recurrence in three and pulmonary metastases in two cases. All cases showed at least focally the light microscopic features of a smooth muscle tumour and demonstrated moderate to strong positivity for alpha-smooth muscle actin. Five were also HHF-35 positive and three were desmin positive. Noteworthy was strong positivity for the 'melanoma associated' antigen NKI/C3 in all cases. Six cases stained also weakly positive for NSE, but all were S-100 protein negative. The former is not specific but is the most reliable marker of lesions showing granular cell change. Granular cytoplasmic change represents simply a cytological phenotype, apparently representing a characteristic metabolic alteration, not exclusively associated with Schwann cell tumours. Tumours containing granular cells are best classified according to their line of specific cellular differentiation if possible.
对9例发生于不同部位、细胞质呈现颗粒细胞改变的平滑肌肿瘤进行了形态学和免疫组织化学研究。患者年龄6至78岁（中位年龄42岁）；7例为女性。2例肿瘤分别发生于真皮或皮下组织，其余5例位于深部软组织。3例病变发生于下肢，2例在骨盆，肘部、肩部、乳腺和臀部各1例。8例患者有随访资料，其中3例出现局部复发，2例发生肺转移。所有病例至少局灶性显示平滑肌肿瘤的光镜特征，α平滑肌肌动蛋白呈中度至强阳性。5例HHF-35阳性，3例结蛋白阳性。值得注意的是，所有病例中“黑色素瘤相关”抗原NKI/C3均呈强阳性。6例NSE也呈弱阳性，但均为S-100蛋白阴性。前者虽不具有特异性，但却是显示颗粒细胞改变病变最可靠的标志物。颗粒状细胞质改变仅仅代表一种细胞学表型，显然代表一种特征性代谢改变，并非仅与施万细胞瘤相关。如果可能，含颗粒细胞的肿瘤最好根据其特定细胞分化谱系进行分类。
