心脏粘液瘤伴腺样结构的形态学研究——附26例的组化、免疫组化和电镜观察

Morphological study of cardiac myxomas with glandular structures——Histochemical,immunohistochemical and electron-microscopic study of 26 cases

本文报告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 见明确的腺样结构外,腺体细胞的胞浆和腺腔内有 PAS 或 AB 染色阳性粘液物质,前者对癌胚抗原、细胞角蛋白、上皮膜抗原呈免疫反应阳性;对波形蛋白、第八因子相关抗原、平滑肌肌动蛋白和 S-100蛋白反应阴性,证实了上皮性质。本文对心脏粘液瘤的组织发生进行了讨论,认为肿瘤可能起源于心内膜下多能性间叶细胞的多向性分化,或者有的亦有产生内胚层细胞特征的能力。

The author reported the clinicopathoiogical,histochemical,immunohistochemical and electron- microscopic study of cardiac myxomas(CMs)in 26 cases.Among them 2 had glandular structure and were proved to be with epithelial differentiation by histochemical and immunohistochemical methods. Beside definite glandular structures,in H & E staining,the glands also had PAS or AB positive mucous materials in their cytoplasms and cavities,with the cytoplasms positive by CK,EMA,CEA and negative by vimentin,factor Ⅷ,smooth muscle actin and S-100 protein,thereby the epithelial characters of the glandular cells was testified.The histogenesis of CMs was disscussed.Because the tumors show epithelial differentiation in addition to multiple meseachymal components,they are considered to originate from multipotential differentiation of the sub-endocardiac multipotential mesenchymal cells,with some of them having the characters of endodermal cells.