Ultrastructural Spectrum of Hemangiopericytoma: A Comparative Study of Fetal, Adult, and Neoplastic Pericytes

Abstract

Since ultrastructural examination is often employed to assess controversial soft tissue tumors, it is important to be aware of the range of differentiation assumed by the tumor cells in hemangiopericytomas. For this purpose, 35 examples (10 localized to the central nervous system and 25 located peripherally) were examined ultrastructurally, and, of these, 20 cases were also studied immunohistochemically for the presence of intermediate filaments and muscle-specific actin. Based on cytologic characteristics evident by electron microscopy, tumor cell differentiation was classed as pericytic (32%), myoid (8%), nondescript (48%), fibroblastic (4%), and histiocytic (8%). Vimentin was the only intermediate filament expressed in the normal pericytes of human fetal and adult tissues and in the neoplastic pericytes of all of the hemangiopericytomas. Muscle-specific actin was present in normal pericytes, but only focally in two of the hemangiopericytomas. In various combinations basal lamina-like materials, cytoplasmic processes, cytoplasmic filaments, discrete basal lamina, and poorly formed intercellular junctions were the most frequently noted features of the tumor cells in hemangiopericytomas, whether central or peripheral, and they assist, along with the organizational relationship of tumor cells and capillaries, in distinguishing this lesion from other soft tissue sarcomas.