肺腺癌の核内封入体

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  • Intranuclear inclusions in adenocarcinoma of the lung.

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Forty-two resected cases of adenocarcinoma of the lung were subjected to cytodiagnostic, histological and electron microscopical examination in order to elucidate the frequency and morphology of intranuclear inclusions, the significance of which is discussed. Intranuclear inclusions could be detected at high rates of 71% by cytodiagnosis, 67% by histological observation and 76% by electromicroscopy. Most of them were cases of simple cytoplasmic invagination (pseudo inclusion) and the detection rate of this type of intranuclear inclusion was 59% with cytodiagnosis, 40% with histological observation and 73% with electronmicroscopy. Cells demonstrating intranuclear tubular structures and finely granulated materials (true inclusion) could be detected at the relatively low rates of 27% by cytodiagnosis, 40% by histopathology and 9.8% by electron microscopy. When these adenocarcinomas were classified by degree of differentiation of the tumor using cytodiagnosis, 32% were found to be highly differentiated, 22% to be moderately differentiated and 18% to be poorly differentiated. If they were classified using the histological method, 59% were highly differentiated, 11% were moderately differentiated and 27% were poorly differentiated, suggesting a lack of large differences between results of the two methods except for highly differentiated adenocarcinomas.<BR>The origin of intranuclear inclusions is not clear. However, the relationship of intranuclear inclusions to either type II alveolar cells or clara cells was suggested, and a positive relationship with prognosis was recognized.<BR>Examination of intranuclear inclusions in the tumor cells of surgical material, bronchial biopsy and brush cytology appears to be important in order to elucidate histological type and prognosis.

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