10例癌肉瘤的光镜及角蛋白免疫细胞化学

CARCINOSARCOMA—A LIGHT MICROSCOPICAL AND KERATIN IMMUNOCYTOCHEMICAL STUDY OF 10 CASES

本研究结果示肉瘤样成份与癌灶相比,二者不仅在形态及某些功能特点上不同,而且在免疫角蛋白的表达方面也呈现出显著差异,各例之癌灶不论其为鳞癌,囊腺癌或导管癌,也不论其分化程度如何均呈现出不同强度的棕色角蛋白阳性颗粒,而肉瘤成份则无1例为阳性,提示本组病例中的两种成份各源于上皮及间叶细胞.本病肉瘤样成份形态多样,据此将该瘤分为梭形细胞型、巨细胞瘤型、腺泡型及多形细胞型等四种组织类型。

Ten cases of carcinosarcoma in oral cavity,esophagus,upper respiratory tract,and breast were separately studied withlightmicroscopy and immun(?)pikeratin assay.Mo(?)phologically,all of these tumor were composed of 2 kinds of componentsproportions.Because 1)the positive granules of keratin weredemonstrated in the cytcplasms of the carcinomatous cellswhile the sarcomatoid cells were negative in all the caseswith double PAP,amd 2)the argyrophilic fibers and thincells,such feature suggest that the two components of thetumors in this originated from epithelium andmesoderm cells respectively.As the sarcomatoid elementof these tumors had very different structures,four distino-tive histologic types were divided:spindle cell type,giantcell tumors type,aleveolar and pleomorphic types.In the lit-(?)rature which we have reviewed,there were no reportsabout the cases of alveolar and/or giant celltype occourrd in breast tissue.The case reported in ourseries is of great importance.