Department of Pathology, The University of Colorado School of Medicine, Aurora, CO, USA.
Brain Pathol. 2013 Sep;23(5):495-514. doi: 10.1111/bpa.12068. Epub 2013 Jul 5.
This article reviews recent literature on sellar region masses that most closely mimic nonsecretory pituitary adenomas: hypophysitis, pituicytoma, spindle cell oncocytoma, and granular cell tumor of neurohypophysis. Even today, these four entities often cannot be confidently distinguished from each other clinically or by preoperative neuroimaging features. Thus, they often come to biopsy/surgical resection and require tissue confirmation of diagnosis. Causes of secondary and primary hypophysitis will be discussed, including two newly described types, IgG4 plasma cell hypophysitis and hypophysitis caused by anti-cytotoxic T-lymphocyte antigen 4 antibody therapy for cancer. For the neoplastic conditions, emphasis will be placed on literature that has emerged since these entities were first codified in the 2007 World Health Organization fascicle. The finding that immunohistochemical staining for thyroid transcription factor-1 is shared by pituicytoma, spindle cell oncocytoma, and granular cell tumor of neurohypophysis suggests common lineage and explains why histological overlap can be encountered. We incorporate our own experiences over the last 30 years from two referral institutions with specialty practices in pituitary region masses.
这篇文章回顾了最近关于鞍区肿块的文献，这些肿块最类似于无分泌功能的垂体腺瘤：垂体炎、垂体细胞瘤、梭形细胞嗜酸细胞瘤和神经垂体颗粒细胞瘤。即使在今天，这四种实体在临床上或术前神经影像学特征上仍难以明确区分。因此，它们经常需要进行活检/手术切除，并需要组织学诊断。将讨论继发性和原发性垂体炎的病因，包括两种新描述的类型，即 IgG4 浆细胞性垂体炎和抗细胞毒性 T 淋巴细胞抗原 4 抗体治疗癌症引起的垂体炎。对于肿瘤性疾病，重点将放在自 2007 年世界卫生组织专刊首次对这些实体进行分类以来出现的文献上。免疫组织化学染色甲状腺转录因子-1 在垂体细胞瘤、梭形细胞嗜酸细胞瘤和神经垂体颗粒细胞瘤中均有表达，提示它们具有共同的谱系，并解释了为什么会出现组织学重叠。我们结合了过去 30 年来自两个专门从事垂体区域肿块的转诊机构的经验。
