浆膜腔积液中转移性腺癌和恶性间皮瘤的电镜诊断

Application of electron microscopy in diagnosis between malignantmesothelioma and metastatic adenocarcinoma in malignant effusions

作者用透射电镜观察了１４例瘤性浆膜腔积液，并与常规细胞学光镜检查进行了比较．结果，光镜诊断的胸腹膜转移性腺癌（ＡＣ）４例中，电镜证实其中３例为ＡＣ，１例为恶性间皮瘤（ＭＭ）；光镜诊断的９例ＭＭ中，电镜诊断其中７例为ＭＭ，２例为ＡＣ．电镜技术的应用为区别瘤性胸腹水中瘤细胞的组织起源提供了客观的依据，解决了常规细胞学检查对ＡＣ和ＭＭ鉴别诊断的困难，提高了ＭＭ细胞学诊断的准确性．

Fourteen cases of tumorous effusion specimens were examined by EM and optical microscopy inde-pendently. Nine effusions were identified as malignant mesothelioma( MM )by routine cytologic examina-tion,while EM correctly diagnosed seven as MM and two as metastatic adenocarcinoma (AC).In the four ef-fusions identified as AC by cytologic method,one case was confirmed as MM by EM. EM resolved the differ-ential diagnosis of MM versus AC in some cases in which routine cytologic examination could not.It showedthat in a diagnosis of tumorous effusion,EM was superior to light microscopy in determining origin of tu-mors,especially in establishing a correct diagnosis of MM.