Houdouin Laurence, Polivka Marc, Henegar Corneliu, Blanquet Alexandre, Delalande Olivier, Mikol Jacqueline
Service d'Anatomie et de Cytologie Pathologiques, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris cedex 10.
Ann Pathol. 2003 Sep;23(4):349-54.
We report two cases of pituitary germinomas in two young men aged 13 and 21, revealed by insipidus diabetes associated with visual field defects or hypopituitarism. Neuroimaging of the first case was initially normal, then showed an infiltration of the stalk; the lesion of the second case appeared as a nodular thickening of the stalk and subsequently a pituitary infiltration. Histologically they mimicked lymphocytic infundibulo-neuro-hypophysitis (LINH) or lymphocytic hypophysitis (LH), the large tumoral clear cells being out-numbered by the heavy inflammatory stroma or mistaken for macrophages. Only the immuno-staining by placental alkaline phosphatase led to the diagnosis. In these tumours, immunostaining positive for CD-117 and negative for CD30, confirmed the diagnosis and should allow the distinction of pituitary germinoma from other germ cell tumours as recently described in the testis, and may have a therapeutic interest.
我们报告了两例垂体生殖细胞瘤，患者为两名分别13岁和21岁的年轻男性，表现为与视野缺损或垂体功能减退相关的尿崩症。第一例患者的神经影像学检查最初正常，随后显示垂体柄有浸润；第二例患者的病变表现为垂体柄结节状增厚，随后出现垂体浸润。组织学上，它们类似于淋巴细胞性漏斗-神经垂体炎（LINH）或淋巴细胞性垂体炎（LH），大量肿瘤性透明细胞被大量炎性基质掩盖或被误认为巨噬细胞。只有胎盘碱性磷酸酶免疫染色才能确诊。在这些肿瘤中，CD-117免疫染色阳性而CD30免疫染色阴性，这证实了诊断，并有助于将垂体生殖细胞瘤与最近在睾丸中描述的其他生殖细胞肿瘤区分开来，可能具有治疗意义。
