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本文报道了经光镜,电镜及免疫组比观察而确诊的8例胚胎性横纹肌肉瘤(ERMS),对照观察了不同分化的ERMS在光镜与电镜下的形态特征。结果发现:分化较好的ERMS光镜下可找列明确的横纹,电镜下一般易找到明显的肌节结构;低分化或未分化的ERMS中,在光镜下仔细寻找向横纹肌分化迹象的细胞,特别是小圆形横纹肌母细胞尤为重要。其形态特征为圆形或卵圆形,细胞质稍多,嗜酸性,核染色质粗,核仁明显,核膜清,其对诊断有重要意义。电镜下见不到典型肌节,但有或多或少的粗细肌丝,呈涡轮状排列,可见少许或不典型Z样物质,仔细寻找粗细肌丝横断面的六角点排列,对诊断有确定意义。本文讨论了在组织学上容易混淆的圆形细胞肿瘤的诊断及鉴别诊断和免疫组化肌红蛋白对RMS的诊断及鉴别诊断上的意义。
In this paper, 8 cases of embryonal rhabdomyosarcoma (ERMS) diagnosed by light microscopy, electron microscopy and immunohistochemistry were compared. The morphological characteristics of differently differentiated ERMS under light and electron microscopy were observed. The results showed that: Under well-differentiated ERMS light microscopy, definite horizontal stripes can be found. Under the electron microscope, obvious sarcomere structure is generally easy to find; in poorly-differentiated or undifferentiated ERMS, the signs of differentiation to striated muscle are carefully searched under the light microscope. Cells, especially small round striated myoblasts, are particularly important. Its morphological characteristics are round or oval, slightly more cytoplasm, eosinophilic, coarse nuclear chromatin, obvious nucleoli, clear nuclear membrane, which is of great significance for diagnosis. Electron microscope can not see the typical sarcomere, but there are more or less thick and thin filaments, arranged in a turbo-shaped, can see a little or atypical Z-like substances, carefully looking for the hexagonal point of the cross section of the thick and thin filaments, the diagnosis is determined significance. This article discusses the diagnostic and differential diagnosis of histologically confusing circular cell tumors and the significance of immunohistochemistry for the diagnosis and differential diagnosis of RMS.