甲状腺血管筋肉腫と考えられた一例

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Use of electron microscopy to establish the correct diagnosis in cases of cancer has been emphasized by many investigators. The patient presented here had been initially diagnosed (light microscope) as undifferentiated carcinoma, but a leiomyosarcoma was the final diagnosis, as the characteristic ultrastructure could be demonstrated under the electron microscope.A 25-year-old Japanese male had a rapidly enlarging cervical tumor which was resistant to irradiation and anti-cancer drugs. The recurrent nerve on the left side was paralysed. Both the cervical trachea and esophagus were depressed and moved to the right. Scintigram of the thyroid showed a cold nodule in the left lobe. Biopsy specimens were removed for histological examination. Permission for autopsy was denied.Under the light microscope, elongated or round tumor cells with large, atypical nuclei and a clear nucleolus were infiltrated diffusely into the edematous and fibrous connective tissue without demonstrating any special pattern or structure.Specimens for electron microscopy were fixed in 2% glutaraldehyde and post fixed in 2% osmium tetraoxide, and double stained with uranyl acetate followed by lead citrate. The tumor consisted of two distinct cellular populations, light and dark. In both cell types, characteristic fine cytoplasmic filaments, similar to myofilaments, were seen in great abundance. These filaments were approximately 60Å in width, contained scattered dense bodies and were seen as bundles surrounding the nuclei. Cytoplasmic organelles such as mitochondria, Golgi apparatus and rough endoplasmic reticulum were slightly condensed around the nuclei with numerous free ribosomes distributed in the cytoplasm. The cytoplasmic membrane showed frequent and irregular interdigitation with occasional desmosomes. A few pinocytotic vesicles were seen. The basement membrane was absent.
耳鼻咽喉科臨床学会の論文

甲状腺血管筋肉腫と考えられた一例

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