心脏粘液瘤伴腺样结构的形态学研究

ORPHOLOGICAL STUDY OF CARDIAC MYXOMAA WIH ADENOIDLIKE STRUCTURES

报告２６例心脏粘液瘤的临床病理、组化、免疫组化和电镜研究。其中２例有腺样结构，经组化和免疫组化染色等证实有上皮分化。除ＨＥ染色见明确的腺样结构外，腺体细胞的胞浆和腺腔内有ＰＡＳ或ＡＢ染色性粘液物质，前者对癌胚抗原、细胞角蛋白、上皮膜抗原呈阳性免疫反应；对波形蛋白、第因子相关抗原、平滑肌肌动蛋白和Ｓ－１００蛋白反应阴性。并对心脏粘液瘤的组织发生进行了讨论，认为肿瘤可能源于心内膜下多能性间叶细胞的多向性分化，有的亦有产生内胚层细胞特征的能力。

The clinicopathological, histochemical, immunohistochemical and electronmicroscopicstudy of cardiac myxomas (CMs ) in 26 cases is reported in this paper. Among them, 2 had adenoidlikestructure and were confirmed to be with epithelial differentiation by histohemical and immunohis-tochemical methods. Besides the adenoidllke structures in HE staining, PAS or AB positive mucous mate-rials were found in cytoplasms and cavities, with cytoplasms positive by CK, EMA, CEA and negative hyvimentin, factor , smooth muscle actin and S-100 protein, thereby the epithelial characters of the glan-dular cells were testified. Histogenesis of CMs was discussed. Because the tumors show epithelial diffiren-tiation in addition to multiple mesenchyamal components. It is considered that they may originate frommultipotential differentiation of the subendocardiac multipotential mesenchyamal cells, with some of themhaving the charcaters of endodermal cells.