软骨样脊索瘤的超微病理对比研究

目的：探讨软骨样脊索瘤的超微病理特点，为阐明此肿瘤的来源提供线索。方法：结合光镜、免疫组化及临床资料，对3例软骨样脊索瘤和4例普通的脊索瘤进行了超微结构对比观察。结果：1．在软骨样脊索瘤的软骨样区域，胞膜游离，形成棘突和微绒毛样突起；在非软骨样区域，瘤细胞排列紧密，粗面内质网发达。2．普通的脊索瘤，一些瘤细胞粗面内质网扩张、融合，挤压瘤细胞核至一侧。结论：1．软骨样脊索瘤出现了两个不同分化的层面，既有分化原始的类似胚胎脊索的瘤组织，又有分化高的软骨样区域，而普通的脊索瘤仅有单一的分化层面。2．软骨样脊索瘤的瘤细胞属同一起源，即胎儿的脊索残余。3，瘤组织的黏液性间质成分是由瘤细胞的粗面内质网合成的。液滴状细胞是部分瘤细胞由于粗面内质网高度扩张而成。

Electron microscopic studies on chordomas:difference between typical chordomas and chondroid chordomas

Objective: To character ultrastructural features of chondroid chordomas and provide some ultrastructural clues to clarify its origin of tumor cells. Method: 3 cases of chondroid chordomas and 4 cases of typical chordomas were selected randomly. Specimens were treated with routine pathological and TEM procedures, immunohistochemical staining, and examined by light-and electron-microscope. Clinical findings were analyzed, too. Results: 1. The chondroid chordomas show isolated `scalloped'cell embedded within an abundant mucoid matrix in the chondroid area of the tumor cells. In the non-chondroid area, the tumor cells which have abundant rough endoplasmic reticulum (RER) in the cytoplasm are in close contact with each other. 2. Typical chordoma show RER dilatation, and forming prominent cytoplasmic vacuolation. Conclusion: 1. Chondroid chordoma have two stages of cell differentiation, the low differentiated cells resemble embryo notochord, while the high differentiated chondroid area have typical differentiated chordomas. 2. All tumor cells of chondroid chordoma have the same origin of the remnant of embryonic notochord. 3. The mucoid matrix of tumor cells, viz. granular material in large extracellular spaces, was synthesized in RER of tumor cells, and the physaliferous cells were as a result of heavily dilatation of RER.