CECAL ADENOCARCINOMA WITH RHABDOID PHENOTYPE - AN IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL ANALYSIS
CECAL ADENOCARCINOMA WITH RHABDOID PHENOTYPE - AN IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL ANALYSIS
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DOI：
10.1007/bf01607171
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发表时间：
1993-02-01
期刊：
影响因子：
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通讯作者：
BHATHAL, PS
中科院分区：
文献类型：
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作者：
CHETTY, R;BHATHAL, PS
一名72岁女性的息肉样盲肠腺癌在显微镜下被发现主要由横纹肌样细胞组成。肝脏和淋巴结中的沉积物具有与原发肿瘤相似的组织学外观。横纹肌样细胞的特点是丰富的嗜酸性细胞质、偏心的细胞核和突出的核仁。鉴别诊断包括横纹肌肉瘤、化生性癌（肉瘤样去分化癌）、癌肉瘤和肾外横纹肌样瘤。横纹肌样细胞与细胞角蛋白、上皮膜抗原和波形蛋白表现出强烈的免疫反应性。在超微结构上，注意到中间丝的细胞质螺旋。多个切片、免疫组织化学和超微结构检查均显示出与横纹肌样区域混合的腺癌成分。在一个区域的恶性腺体内存在横纹肌样细胞。该病例说明，许多肿瘤的横纹肌样外观可能会产生误导，而仅仅是在肾外部位看到的非特异性形态表型模式。在肾外环境中，应仔细寻找分化的证据。
A polypoid caecal adenocarcinoma in a 72-year-old female was found microscopically to be composed mainly of rhabdoid cells. Deposits in the liver and lymph nodes had a similar histological appearance to the primary tumour. The rhabdoid cells were typified by abundant eosinophilic cytoplasm, eccentric nuclei and prominent nucleoli. The differential diagnosis included rhabdomyosarcoma, metaplastic carcinoma (carcinoma with sarcomatoid dedifferentiation), carcinosarcoma and extra-renal rhabdoid tumour. The rhabdoid cells showed strong immunoreactivity with cytokeratin, epithelial membrane antigen and vimentin. Ultrastructurally, cytoplasmic whorls of intermediate filaments were noted. Multiple sections, immunohistochemistry and ultrastructural examination all revealed an adenocarcinomatous component which blended with the rhabdoid areas. In one area a rhabdoid cell was present within a malignant gland. This case illustrates that the rhabdoid appearance of many tumours can be misleading and is merely a non-specific morpho-phenotypic pattern seen in extra-renal sites. In the extra-renal setting, careful search for evidence of differentiation should be under-taken.