Current basis for the ultrastructural clinical diagnosis of tumors: A review

The ultrastructural diagnosis of tumors requires a careful analysis that should be done in an orderly fashion. It requires precise planning from the time of specimen collection to the selection of the area to be examined. Pictures must be taken systematically and every micrograph should allow to answer whether the number of cells photographed is adequate; whether mitoses are present, what is the pattern of the tumor; what is the appearance of the cell membrane; whether the cells are joined by junctional complexes; whether free surfaces possess microvilli or cilia; what organelles are present and how they are distributed; whether there are secretory granules, melanosomes, or other cytoplasmic elements. Nuclear and nucleolar size and shape have to be taken into consideration. The composition of the interstitial extracellular matrix is important in certain types of tumors. Although these questions are not the only ones to be addressed, their use in a logical fashion is helpful when it concerns the ultrastructural diagnosis.