喉頭紡錘細胞癌症例—その免疫組織学的検討

Spindle Cell Carcinoma of the Larynx:Immunohistochemical Studies

緒言

　紡錘細胞癌は扁平上皮癌の稀な一亜型であり，口腔，咽頭，上気道などに比較的多くみられる。臨床的に腫瘍は一般に球状の有茎性腫瘤であることが多く，組織学的には紡錘形の細胞が充実性に増生し一見肉腫様を呈する。この紡錘形細胞のhis—togenesisに関しては種々の議論があるが一般に扁平上皮由来であると考えられている。我々は，喉頭ポリープの診断にて喉頭微細手術を施行し，病理診断にて紡錘細胞癌であった1例を経験したので，病理組織学的所見について検討し，併せて文献的考察を加えて報告する。

In a 64-year-old female a lesion appeared as a large, gray, polypoid tumor. Surgical resection and laser irradiation was performed. The histo-logic pattern of this tumor was mainly that of a malignant spindle cell process, but definite squa-mous cell carcinoma component was evident. Specimen was examined for the presence of cy-tokeratin, vimentin, desmin and neurofilament polypeptide by immunohistochemical techniques using monoclonal antibodies. Squamous cell car-cinoma components were cytokeratin-positive, vi-mentin-negative, desmin-negative and NFP-nega-tive, while spindle cell components were vimentin-positive, cytokeratin-negative, desmin-negative and NFP-negative. These findings support the concept that spindle cell carcinoma represents squamous cell carcinoma with the unique ability to present an anaplastic spindle metaplasia. There has been no evidence of recurrence and metastasis.