降钙素瘤的临床及形态学观察(附二例报告)

CLINICAL AND MORPHOLOGICAL INVESTIGATIONS OF CALCiTONINOMA

本文报道一例腹膜后及肝内多发性肿块,另一例为颈部肿块,组织病理学均拟诊为转移性腺癌。根据电镜下瘤细胞内分沁颗粒的形态,并经免疫组化证实为降钙素瘤(即C细胞型APUD瘤),手术治疗后经过良好。作者对诊断的建立、临床治疗及肿瘤起源等进行了讨论。

Two rare cases of calcitoninoma (C cell AP0Doma)were diagnosed by electronmi-croscopic and immunohistochemical evidence though the histopathological findings had failed to sstablish.Bath cases rac^ivad operative tr^atinsnt and recovery was uneventful.The diagnosis is consistent with the follow-up observation so far.Patient A had retroperitoneal and hepatic multiple calcitoninoma and patient B suffered from ectopic thyroid medullar carcinoma.Well differentiated calcitoninoma cells contained special APUD granules which were spherical, membrane bound and measured 300-700nm in diameter.The characteristic APUDamyloid was found in neoplastic cells of palient A, but not in all cells.Patient B had three types of endocrine cells, though the tumor was mainly made up of C cells.Calcitonin-producing C cells were present clearly in two cases with double PAP method.Diagnosis, clinical treatment and the origin of calcitoninoma are discussed.The authors emphasize that electron microscopic and immunohistochemical examinations are important in the diagnosis of APUDoma, and good results might be obtained by early operative treatment.