Hemmi A, Komiyama A, Ohno S, Fujii Y, Katoh R, Yokoyama A, Kawaoi A
Second Department of Pathology, Yamanashi Medical University, Japan.
Virchows Arch. 1998 Apr;432(4):377-83. doi: 10.1007/s004280050181.
A poorly differentiated leiomyosarcoma of the stomach in a 41-year-old woman is reported. The diagnosis was confirmed by the diffuse immunohistochemical reaction to HHF35, and the presence of focal density and caveolas in some of the tumour cells by conventional electron microscopy. Immunohistochemically, most tumour cells had an undifferentiated nature, in which negative immunostaining for desmin, alpha-smooth muscle actin, and type IV collagen, and positive immunostaining for vimentin were observed. By the quick-freezing and deep-etching (QF-DE) method, these tumour cells revealed the loss of bundled actin and myosin filaments, which constitute desmin associated structures (focal densities and dense patchy areas). Their cytoplasm had many mitochondria and other cell organelles. The intermediate filaments (IFs), which were determined to be vimentin by immunohistochemistry, were observed in the inter-organellar spaces, and connected with these cell organelles. Actin filaments formed a meshwork structure and were distributed mainly in subplasmalemmal regions. Although a basal lamina was not detected by conventional electron microscopy, basal lamina-like structures, an association between the extracellular matrices and the cell membrane, were observed. Using the QF-DE method, three dimensional ultrastructural alterations of the cytoskeleton and extracellular matrix of the leiomyosarcoma were observed.
报道了一名41岁女性的胃低分化平滑肌肉瘤。通过对HHF35的弥漫性免疫组化反应以及常规电子显微镜观察到部分肿瘤细胞中存在局灶性密度和小窝，确诊了该病例。免疫组化显示，大多数肿瘤细胞具有未分化的特性，其中结蛋白、α-平滑肌肌动蛋白和IV型胶原免疫染色呈阴性，波形蛋白免疫染色呈阳性。通过快速冷冻和深度蚀刻（QF-DE）方法，这些肿瘤细胞显示构成结蛋白相关结构（局灶性密度和密集斑块区域）的肌动蛋白和肌球蛋白丝束缺失。其细胞质中有许多线粒体和其他细胞器。通过免疫组化确定为波形蛋白的中间丝（IFs）见于细胞器间空间，并与这些细胞器相连。肌动蛋白丝形成网状结构，主要分布在质膜下区域。虽然常规电子显微镜未检测到基底膜，但观察到基底膜样结构，即细胞外基质与细胞膜之间的联系。使用QF-DE方法，观察到了平滑肌肉瘤细胞骨架和细胞外基质的三维超微结构改变。
