1984 年 20 巻 2 号 p. 321-334
Urinary excretion of catecholamines (CA) and their metabolites were measured in 18 cases with neuroblastomas (NB), 10 with ganglioneuroblastomas (GNB) and 3 with ganglioneuromas (GN). CA contentss in the resected tumor tissues of 10 NB, 7 GNB and 4 GN were also determined. On the other hand ultrastructural studies were done in 20 NB, 7 GNB and 4 GN, with special interest in neurosecretory granules of tumor cells. These biochemical data and morphological findings were analyzed and following results were obtained: 1) Measurements of all of VMA, HVA and dopamine in urine were most reliable to make diagnosis of NB, GNB and GN. 2) Initial urinary VMA/HVA. ratio and the level os urinary dopamine closely related to the prognosis of the patients with NB and GNB. 3) The amount of catecholamine contents in the tumor tissues correlated to both the level of urinary CA metabolites and the numbers of neurosecretory granules found in the tumor tissue. 4) CA metabobism in NB and GNB was generally more active than the one in GN. Norepinephrine and dopamine were main catecholamines detected in these tumor tissues, whereas epinephrine was scarce in amount. In urine, VMA, HVA and dopamine were mainly detected. Low levels of Dopamine β-Hydroxylase and small numbers of coated neurosecretory vesicles in tumor tissues were causative of the above metabolic features. 5) Coated vesicles were classified into 5 types according to their size and form. They tended to become larger and to transform into oval in the area where they densely gathered, namely in the presence of high level catecholamine synthesis. 6) In a VIP secreting ganglioneuroma, two types of coated vesicles were seen : the large sized ones (about 130 m/μ) presenting low electron density were presumably relevant to VIP.