颅底脊索瘤的超微结构与临床的相关研究

Skull base Chordoma: Ultrastructure and Clinical Research

报告 41例颅内脊索瘤 (包括 2例软骨样脊索瘤 )的临床表现及组织病理和超微结构特点。脊索瘤的形态学特点为瘤细胞内有大量空泡及间质内的黏液基质 ;免疫组化对角蛋白、上皮膜抗原为阳性表达 ;电镜下可见桥粒、微绒毛以及粗面内质网包绕线粒体等特殊结构。软骨样脊索瘤的形态特点为出现非上皮组织来源的细胞并可见粗面内质网池中微管样结晶。研究结果证实脊索瘤中既有上皮组织分化的特点又有间叶组织的表现 ,还存在着具有多潜能分化的恶性干细胞群体。

Fourty one patients with intracranial chordoma near the base of the skull (including 2 cases chondroid chordoma) are reported along with the clinical features and histopathology and ultrastructure character. This tumor had morphologic features identical to a chordoma: nodular growth with vacuolated cytoplasm and myxomatous stroma by light microscopy, positive immunoreaction for cytokeratin and epithelial membrane antigen by immunohistochemistry, desmosomes, microvilli mitochondria surround by rough endoplasmic reticulum by electron microscopy. The fine structure feature of chondroid chordoma was microtubules which located within the rough endoplasmic reticulum. The ultrastructural research confirmed that the chordoma presented not only epithelial differentiation but also mesenchymal. Some cells were multipotential neoplasms cells in which the stem cells were capable of differentiation along both epithelial and mesenchymal pathways. The results suggest the possibility of altered differentiation pathway of the tumor stem cell emergence of a new malignant cell population within the chordoma.