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目的:探讨肾恶性横纹肌样瘤(MRTK)的临床病理表现及超微结构特点。方法:用光镜、免疫组化及电镜等方法观察其病理组织学特点、免疫组化表达及超微结构。结果:光镜的典型特点是肿瘤细胞弥漫性排列,呈圆形、椭圆形及不规则形,胞质丰富,嗜酸性,部分胞质内可见透明状小体,细胞核圆形或椭圆形,核膜厚,核仁清楚,有的细胞核呈空泡状。部分核偏向一侧似浆细胞样。细胞内外见红染的包涵体。免疫组化显示肿瘤可表达多种抗原。电镜观察特异性表现是胞质内见中间丝及圆形不规则形纤维状或轮状小体。结论:肿瘤细胞弥漫排列呈浆细胞样,免疫组化多方向表达,可向神经性、上皮性、肌性等方向分化。电镜下胞质内中间丝及纤维轮状小体是特异性诊断标志。
Objective: To investigate the clinicopathological and ultrastructural features of renal malignant rhabdomyosarcoma (MRTK). Methods: The pathological features, immunohistochemistry and ultrastructure were observed by light microscope, immunohistochemistry and electron microscope. Results: The typical characteristics of light microscopy were diffuse arrangement of tumor cells, which were round, oval and irregular, rich in cytoplasm and eosinophilic. Some of the cytoplasm showed transparent bodies, round or oval nuclei, Thickness, clear nucleoli, some vacuoles of the nucleus. Part of the nuclear side to the plasmacytoid like. Inside and outside the cell see the red dye inclusion body. Immunohistochemistry showed that the tumor can express a variety of antigens. Electron microscopic observation of the specific performance of the cytoplasm see intermediate filaments and round irregular fibrous or round body. CONCLUSION: The tumor cells diffusely arranged in a plasmacytoid manner and expressed in multiple directions by immunohistochemistry. The tumor cells can differentiate into neurogenic, epithelial and muscular directions. Electron microscopy of cytoplasmic intermediate filaments and fibrous rotosomes are specific diagnostic markers.