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[内分泌器官重要疾病的病理学(不包括甲状腺)]

[Pathology of important diseases of endocrine organs (excluding the thyroid)].

作者信息

Saeger W, Schröder S, Klöppel G

机构信息

Institut für Pathologie des Marienkrankenhauses, Alfredstrasse 9, 22087 Hamburg.

出版信息

Pathologe. 2001 Sep;22(5):296-309. doi: 10.1007/s002920100483.

Abstract

Basic principles of classification of tumors of the pituitary, parathyroid glands, adrenals, paraganglionic system and endocrine pancreas and the differential diagnosis from non-endocrine tumors are presented. There are no uniform criteria of malignancy and common neuroendocrine immunohistological markers for unequivocal identification, as each organ has its own criteria. For pituitary tumors invasive growth is not a sign of malignancy, but only metastases. For tumors of the adrenal cortex a histopathological score has to be used for proving dignity. For pheochromocytomas, structural criteria (mitoses, angioinvasion) and immunostaining (S-100 protein, p53, Ki-67) are important. Endocrine tumors of the pancreas behave differently if they are angioinvasive or if they show more than two mitoses per 10 HPF, more than 2% Ki-67 positive nuclei or a size of more than 2 cm in diameter. They are malignant if gross local invasion or metastases are demonstrable. Clinical data have to be included in pathohistological reports. In many cases immunostaining in addition to structural analysis will be necessary.

摘要

介绍了垂体、甲状旁腺、肾上腺、副神经节系统和内分泌胰腺肿瘤的分类基本原则以及与非内分泌肿瘤的鉴别诊断。目前尚无统一的恶性标准和用于明确识别的常见神经内分泌免疫组织学标志物,因为每个器官都有其自身的标准。对于垂体肿瘤,侵袭性生长并非恶性标志,而是仅代表转移。对于肾上腺皮质肿瘤,必须使用组织病理学评分来确定其性质。对于嗜铬细胞瘤,结构标准(有丝分裂、血管浸润)和免疫染色(S-100蛋白、p53、Ki-67)很重要。胰腺内分泌肿瘤若有血管浸润,或每10个高倍视野有超过两个有丝分裂象、超过2%的Ki-67阳性核或直径超过2 cm,则表现不同。若有明显的大体局部侵犯或转移,则为恶性。病理组织学报告必须包含临床数据。在许多情况下,除结构分析外还需要进行免疫染色。

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