[Ultrastructural observations on transitional cloacogenic carcinomas of the ano-rectal region (author's transl)].

Abstract

The clinical and pathological features of four transitional cloacogenic carcinomas (TCC) are presented with particular reference to electron microscopy. The incidence of this tumour is 1.4% of all ano-rectal neoplasms. Three cases showed a gross appearance similar to the common rectal neoplasms. One tumour presented without an intraluminal lesion, but infiltrated the bowel wall and the anal glands. TCC show a distinct histological pattern. The degree of differentiation of the basic transitional cell component determines the "grading" of the lesion. We distinguish between grade I, II and III. Grade I lesions show uniform polygonal cells with only occasional mitotic figures. There is distinct palisading of the nuclei of the peripheral tumour cell layers. Grade II lesions are characterized by partial or total loss of the peripheral palisading. Grade III lesions are extremely anaplastic ("oat cell" carcinoma). This histological classification correlates well with the prognosis. Electron microscopic investigation of TCC revealed the ultrastructural features of basal cells. The uniform tumour cells with large nuclei contain tonofibrils, desmosomes and hemi-desmosomes, free ribosomes, and relatively few other organelles. We did not find keratinocytes or keratohyalin granules in these four cases of TCC. It is emphasized that TCC of the ano-rectal region differ fundamentally from the basalcell carcinomas of the skin in their biological behaviour.