Saeger W
Endokrinologie. 1978 Feb;71(1):45-59.
Pituitary adenomas should be classified not only by their tinctorial affinities but also by their degree of differentiation. Then useful correlation to the clinical data can be obtained; On this principle our own collection of 299 tumors was classified in undifferentiated acidophilic, highly differentiated acidophilic GH cell-, highly differentiated acidophilic prolactin cell-adenomas, in undifferentiated mucoid cell-, highly differentiated mucoid ACTH cell-, highly differentiated mucoid TSH cell-adenomas, in chromophobic adenomas of small cell type and of large cell type, and in oncocytic adenomas. 95% of the cases with acromegaly based on undifferentiated acidophilic or highly differentiated GH cell adenomas. All patients with hypothalamic-hypophyseal Cushing's syndrome or Nelson's syndrome had undifferentiated mucoid cell adenomas or highly differentiated ACTH cell adenomas. In cases with hyperprolactinemia prolactin cell adenomas or chromophobic adenomas of large cell type with ultrastructurally demonstrated very highly developed rough endoplasmic reticulum or endocrinologically inactive chromophobic adenomas of small cell type were found. In the latter cases the prolactin is probably produced not by the tumor but by the surrounding tumor-free pituitary tissue.
垂体腺瘤不仅应根据其染色亲和力进行分类,还应根据其分化程度进行分类。这样才能与临床数据进行有效的关联;基于这一原则,我们自己收集的299例肿瘤被分类为未分化嗜酸性、高分化嗜酸性生长激素细胞、高分化嗜酸性催乳素细胞腺瘤,未分化黏液样细胞、高分化黏液样促肾上腺皮质激素细胞、高分化黏液样促甲状腺激素细胞腺瘤,小细胞型和大细胞型嫌色性腺瘤,以及嗜酸性细胞瘤。95%的肢端肥大症病例基于未分化嗜酸性或高分化生长激素细胞腺瘤。所有下丘脑-垂体性库欣综合征或尼尔森综合征患者均患有未分化黏液样细胞腺瘤或高分化促肾上腺皮质激素细胞腺瘤。在高催乳素血症病例中,发现了催乳素细胞腺瘤或大细胞型嫌色性腺瘤,其超微结构显示粗面内质网非常发达,或小细胞型内分泌无活性嫌色性腺瘤。在后一种情况下,催乳素可能不是由肿瘤产生的,而是由周围无肿瘤的垂体组织产生的。