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恶性纤维组织细胞瘤的超微结构研究

AN ULTRASTRUCTURAL STUDY OF MALIGNANT FIBROUS HISTIOCYTOMA

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【作者】 张世羽杨光华谭永淑王远萍

【Author】 Zhang Shiyu;Yang Guanghua;Tan Yongshu Department of Pathology Wang Yuanping Electron Microscope Laboratory

【机构】 华西医科大学病理学教研室华西医科大学电子显微镜室

【摘要】 作者报告30例恶性纤维组织细胞瘤(MFH)的电镜及其中28例α1-AT免疫组化研究。电镜见MFH 由以纤维母细胞样细胞为主的多种瘤细胞组成,并得到免疫组化的证实。纤维母细胞样细胞和肌纤维母细胞样细胞均可有明显的多形性,光镜下易被误认为组织细胞。多核瘤巨细胞和黄色瘤细胞可来自多种瘤细胞。本研究结果提示MFH可能源于原始间叶细胞。作者还对MFH 在超微结构水平与其他肿瘤的鉴别诊断进行了讨论。

【Abstract】 The ultrastructural finding of 30 casesof malignant fibrous histiocytoma (MFH) arereported,which were confirmed by electronmicroscope(EM).Of the 30 cases,28 werestained with α1-antitrypsin(α1-AT) by PAPmethod.Emphasis of this study was put onthe tumor cell components and their rela-tionship, histogenesis of the tumor anddifferential diagnosis based on the ultra-structural level. The results of this ultrastructural studyshowed that the MFH were composed of anadmixture of various types of tumor cells,including fibroblast-like, histiocyte-like,intermediate, myofibroblast-like, primitivemesenchymal, xanthomatous, and multinu-cleated tumor giant cells.In all lesions, thefibroblast-like cells were the prominantcells,which was confirmed by immunohisto-chemical study. Both fibroblast-like and myofibroblast-like cells were obviously pleomorphic inappearance,some of which were oftenregarded as histiocytes by LM.The multinu-cleated giant cells and xanthomatous cellsmay derive from fibroblast-like, histiocyte-like, intermediate or myofibroblast-likecells. Our study supports the concept thatthe tumor arises from primitive mesenchy-mal cells that are capable of differentiating toward different cell lines, in par-ticular,toward fibroblast-like cells. In addition,on ultrastructural level thedifferentiation of MFH from the tumors,including rhabdomyosarcomas, liposarcomas,dermatofibrosarcoma protuberans, spindlecell squamous carcinomas,malignant neuro-fibromas and osteosarcomas, which tend tobe confused in diagnosis with MFH, is alsodiscussed.

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