Gatalica Z, Miettinen M, Kovatich A, McCue P A
Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5244, USA.
Hum Pathol. 1997 Apr;28(4):400-3. doi: 10.1016/s0046-8177(97)90026-5.
Hyaline globules (extracellular collections of amorphous material) are identified in 10 of 59 renal cell carcinomas (RCC) and in 2 of 9 oncocytomas. Immunohistochemical characterization of these PAS-positive structures revealed the presence of basement membrane material in most cases. Collagen type IV and laminin were the predominant constituents, whereas fibronectin was detected only occasionally. Electron microscopic examination of the globules showed concentric multilayered accumulations of basement membrane material. No such structures were recognized in 8 renal pelvic transitional cell carcinomas nor in 2 metanephric adenomas. RCC associated hyaline globules were always negative for alpha1-antitrypsin (AAT), alpha-fetoprotein (AFP), amyloid A, cytokeratin, vimentin, or lysozyme. These features differ from those of the hyaline globules previously described in other malignant neoplasms, notably AAT-positive hyaline globules in ovarian tumors, and AFP-positive globules in yolk sac tumors. Identification and immunohistochemical characterization of hyaline globules in metastases may be helpful in determining the origin of occult primary tumors.
在59例肾细胞癌(RCC)中有10例以及9例嗜酸细胞瘤中有2例发现了透明小球(无定形物质的细胞外聚集体)。对这些PAS阳性结构进行免疫组织化学特征分析发现,大多数情况下存在基底膜物质。IV型胶原和层粘连蛋白是主要成分,而纤连蛋白仅偶尔被检测到。对小球进行电子显微镜检查显示基底膜物质呈同心多层堆积。在8例肾盂移行细胞癌和2例后肾腺瘤中未发现此类结构。与RCC相关的透明小球对α1-抗胰蛋白酶(AAT)、甲胎蛋白(AFP)、淀粉样蛋白A、细胞角蛋白、波形蛋白或溶菌酶始终呈阴性。这些特征与先前在其他恶性肿瘤中描述的透明小球不同,特别是卵巢肿瘤中AAT阳性的透明小球以及卵黄囊瘤中AFP阳性的小球。转移灶中透明小球的鉴定和免疫组织化学特征分析可能有助于确定隐匿性原发肿瘤的起源。