Saeger W, Breuer H, Lüdecke D
Beitr Pathol. 1976 May;157(4):367-90. doi: 10.1016/s0005-8165(76)80051-0.
Chromophobe adenomas have been defined by the absence of secretory granules in them. But this definition has become doubtful since a granulation could be electron microscopically demonstrated. Hence we studied a collection of more than 100 surgically removed pituitary adenomas in order to find precise morphological criteria for the differential diagnosis of chromophobe adenomas, specially from the sparsely granulated chromophilic tumors. Furthermore we tried to find relations between the amount and type of granulation of the tumor cells and the clinical endocrine hyperfunction.
108 unselected pituitary tumors were studied by light and electron microscopic methods. For histology the tissue was fixed in Helly's fluid or in buffered formalin. The paraffin wax sections were stained with haematoxylin-eosin, PAS, gallocyanin-chrome alum, carmoisine L-orange G-wool green, Herlant's tetrachrome method, and performic acid-alcian blue-PAS-orange G. For electron microscopy small pieces of the tumor were fixed in buffered glutaraldehyde, postfixed in osmium tetroxide, and embedded in epon 812. Sections were stained with toluidine blue for light microscopy. Thin sections were stained with uranyl acetate and lead citrate. Electron microscopical pictures with a primary magnification of 4000 were semi-quantitatively judged for the content and the extent of rough endoplasmic reticulum, Golgi complexes, secretory granules, lysosomes, and mitochondria by a grading with 6 degrees. Results. With special stains and the electron microscope 46 adenomas could be identified which consisted only of slightly granulated or agranular cells but not of densely granulated cells. These were defined as chromophobe adenomas. Oncocytic adenomas were regarded as another tumor type and were not included. One half of the chromophobe adenomas showed ultrastructurally well developed protein-synthesizing organellas. The diameter of the secretory granules amounts up to 500 mum. One quarter had many autolysosomes or lipid droplets. On the other hand, 18 adenomas of our collection exhibited moderate acidophilic granulation with only a few denser or fully granulated cells. These were designated as sparsely granulated acidophilic adenomas. They were rich in organelles. 89% of them showed a well developed rough endoplasmic reticulum and large Golgi complexes as signs of high endocrine activity. The secretory granules had diameters between 200 and 600 upsilonm. The autolysosomes were for the most part small and rare. The 20 fully granulated acidophilic adenomas could be easily recognized and are not discussed in this paper. The sparsely granulated mucoid cell-adenomas were easily identified by a positive PAS-reaction.
From our studies we conclude that chromophobe adenomas exhibit only sparse granulation and no denser or fully granulated tumor cell...
嫌色性腺瘤的定义是其细胞内不存在分泌颗粒。但自从通过电子显微镜能够证实有颗粒形成后，这一定义就受到了质疑。因此，我们研究了100多例手术切除的垂体腺瘤，以便找到用于鉴别诊断嫌色性腺瘤，特别是与颗粒稀少的嗜色性肿瘤鉴别的精确形态学标准。此外，我们试图找出肿瘤细胞颗粒的数量和类型与临床内分泌功能亢进之间的关系。
采用光镜和电镜方法对108例未经选择的垂体肿瘤进行了研究。组织学检查时，组织用Helly氏液或缓冲甲醛固定。石蜡切片用苏木精-伊红、PAS、胆青素-铬明矾、卡红L-橙G-羊毛绿、赫兰特氏四色法以及过甲酸-阿尔辛蓝-PAS-橙G染色。电镜检查时，将小块肿瘤组织用缓冲戊二醛固定，再用四氧化锇后固定，然后包埋于Epon 812中。切片用甲苯胺蓝染色用于光镜观察。超薄切片用醋酸铀和柠檬酸铅染色。对放大4000倍的电镜照片，通过6级评分对粗面内质网、高尔基体、分泌颗粒、溶酶体和线粒体的含量及范围进行半定量判断。结果：通过特殊染色和电镜，可识别出46例腺瘤，这些腺瘤仅由颗粒稀少或无颗粒的细胞组成，而无颗粒密集的细胞。这些被定义为嫌色性腺瘤。嗜酸性细胞瘤被视为另一种肿瘤类型，未包括在内。一半的嫌色性腺瘤在超微结构上显示蛋白质合成细胞器发育良好。分泌颗粒直径可达500μm。四分之一的嫌色性腺瘤有许多自溶体或脂滴。另一方面，我们收集的18例腺瘤表现为中等嗜酸性颗粒，仅有少数颗粒较密集或完全充满颗粒的细胞。这些被称为颗粒稀少的嗜酸性腺瘤。它们富含细胞器。其中89%显示粗面内质网发育良好且高尔基体大，这是内分泌活性高的标志。分泌颗粒直径在200至600μm之间。自溶体大多小且少见。20例颗粒完全充满的嗜酸性腺瘤很容易识别，本文不再讨论。颗粒稀少的黏液性腺瘤通过PAS反应阳性很容易识别。
从我们的研究中我们得出结论，嫌色性腺瘤仅表现为颗粒稀少，不存在颗粒较密集或完全充满颗粒的肿瘤细胞……
