Monteagudo C, Jordá E, Carda C, Illueca C, Peydró A, Llombart-Bosch A
Department of Pathology, University Hospital, University of Valencia, Spain.
Histopathology. 1997 Oct;31(4):367-73. doi: 10.1046/j.1365-2559.1997.2670867.x.
Erythrophagocytosis is a characteristic feature of tumour cells in malignant histiocytosis, some leukaemias, lymphomas, and also reactive histiocytes in the haemophagocytic syndrome associated with a variety of infections and neoplasms. It has also been found exceptionally in metastatic malignant epithelial cells in bone marrow and lymph nodes. We present two cases, a cutaneous malignant melanoma and an acantholytic squamous cell carcinoma, in which erythrophagocytosis by tumour cells was demonstrable by both light and electron microscopy.
The melanocytic and squamous nature of these cells was supported by the immunohistochemical detection of HMB45, S100, and NKI-C3 in the former, and cytokeratin and EMA in the latter, and at ultrastructural level by the presence of melanosomes and tonofilaments, respectively.
This is, to our knowledge, the first documented report of erythrophagocytic tumour cells in human melanomas and primary carcinomas. Biological considerations apart, this unusual feature can prove to be of value to avoid a misdiagnosis of a variety of haematopoietic malignancies.
红细胞吞噬现象是恶性组织细胞增多症、某些白血病、淋巴瘤中肿瘤细胞的特征性表现,在与多种感染和肿瘤相关的噬血细胞综合征中的反应性组织细胞中也有此现象。在骨髓和淋巴结的转移性恶性上皮细胞中也有罕见发现。我们报告两例病例,一例皮肤恶性黑色素瘤和一例棘层松解性鳞状细胞癌,通过光学显微镜和电子显微镜均证实肿瘤细胞存在红细胞吞噬现象。
通过免疫组化检测,前者检测到HMB45、S100和NKI-C3,后者检测到细胞角蛋白和EMA,支持了这些细胞的黑素细胞和鳞状细胞性质,在超微结构水平上,分别通过黑素小体和张力丝的存在得以证实。
据我们所知,这是关于人类黑色素瘤和原发性癌中红细胞吞噬性肿瘤细胞的首次文献报道。除生物学方面的考虑外,这一不寻常特征可能有助于避免对多种造血系统恶性肿瘤的误诊。