恶性间皮瘤的超微结构诊断和鉴别诊断

本文对17例恶性间皮瘤和20例胸腹膜转移癌进行了超微结构对照观察。研究结果表明,恶性间皮瘤瘤细胞表面和瘤细胞内腔表面均有细长蓬发样微绒毛,瘤细胞胞浆内有丰富的张力微丝,并见多量桥粒。相反,转移癌的微绒毛则短小,呈单个散在分布,而且转移腺癌的张力微丝稀少或缺乏。转移性腺癌有微绒毛根(17/20)、板层小体(6/20)、纤毛(12/20)、糖萼小体(17/20)和粘液分泌颗粒(18/20),而恶性间皮瘤则缺乏这些表现。提示恶性问皮瘤和胸腹膜转移癌鉴别发生困难时,作电镜观察是必要的。

Ultrastructural diagnosis and differential diagnosis of malignant mesothelioma

In this paper, 17 cases of malignant mesothelioma and 20 cases of metastatic carcinoma of the pleura and peritoneum were pathologically compared by the use of electron microscopes. It was found that malignant mesothelioma is characterized by the presence of long bush-like microvilli on the surfaces of tumor cells and intracellular lumina and abundant tonofilaments in the cytoplasm of tumor cells. In contrast, the metastatic carcinoma studied shows relatively short, simble microvilli and scanty or no tonofilaments in metastatic adenocarcinoma. Metastatic adenocarcinoma showed microvillous rootlets (17/20), lamellar bodies (6/20), cilia(12/20), glycocalyceal bodies (17/20) and mucinous secretory granules(18/20), which were absent in malignant mesothelioma. For the purpose to provide an accurate diagnosis for the clinician, it is necessary to study electron-microscopically for differentiating malignant mesothelioma from difficult metastatic carcinoma of pleura and peritoreum. In addition, ultrastructural diagnostic criteria of the malignant mesothelioma have been investigated too.