抄録
Clinicopathological studies have been carried out in 28 cases with neuroblastoma and following results were obtained. 1) The prognosis in the 28 children was affected by age when the treatment was initiated, the primary site of the tumor and the stage of the disease. 2) In electron microscopic studies, neuroblastoma tissue was classified into four types, which are immature, low differentiated, differentiated and ganglionic. 3) Three types of catecholamine granules were seen. First, catecholamine granules in round shape with the diameter of about 50 nm were located mostly in nerve processes, Secondly, the granules with the diameter of about 100 nm were also round shaped, and located in the tumor cells and nerve processes. Thirdly, the granules of oval shape with different diameters were present in the cells with many round catecholamine granules. 4) Morphological true synaps was found only in the differentiated tissue from the tumor. In the undifferentiated tissue, synaps-like structure without the cluster of synaptic vesicles or desmosome was observed. Synaptic element was not found in the tissue of the immature type. 5) No significant differences in ultrastructures of neuroblastoma were recognized among the specimens from various age groups. It is considered that good prognosis of infants under 12 months of age with the tumor is more related to host factors rather than to tumor cell factors. 6) Neuroblastoma originated from extraadrenal tissue had more differentiated ultrastructure than adrenal neuroblastoma. In three cases of extraadrenal neuroblastoma giant mitochondria were observed, but in cases of adrenal neuroblastoma they were absent. 7) In one case,concentric lamination was found encircling the tumor cell. This lamination structure was identified as nerve processes. In another case glycogen granules were found in the cytoplasm and nerve process of the low differentiated type of tumor cells. 8) Electron microscopic change was found in Ithe tumor cells from neuroblastoma after conventional chemotherapy and radiation. In two patients so treated marked proliferation and tangle of neurofilaments in the cytoplasm and neuropiles were induced by vincristine.
