Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, ON, M5G 2C4, Canada.
Endocr Pathol. 2013 Sep;24(3):162-6. doi: 10.1007/s12022-013-9256-9.
This report describes a case of pituitary adenoma with interspersed adrenal cortical cells. The pituitary cells were confirmed to be corticotrophs with Tpit and adrenocorticotropic hormone immunohistochemistry, whereas the adrenal cortical cells were verified to be such with steroidogenic factor-1 (SF-1), inhibin, calretinin, and Melan A staining. The presence of normal adrenal cortical cells in the heterotopic location of the sella fulfills the definition of choristoma. The origin of adrenal cortical cells within a pituitary adenoma remains unexplained. The important role of SF-1 in both pituitary and adrenal cortex may explain a relationship that supports the possibility of an abnormal proliferation and differentiation of uncommitted mesenchymal stem cells within the sella. However, it remains possible that misplaced adrenal cortical cells derived during embryogenesis give rise to this rare but distinct morphological entity that can pose a difficult diagnostic dilemma. The approach to differential diagnosis is discussed.
本报告描述了一例垂体腺瘤伴肾上腺皮质细胞交错的病例。通过 Tpit 和促肾上腺皮质激素免疫组织化学证实垂体细胞为促皮质素细胞，而肾上腺皮质细胞通过类固醇生成因子-1（SF-1）、抑制素、钙视网膜蛋白和黑素 A 染色得到证实。鞍内异位存在正常肾上腺皮质细胞符合错构瘤的定义。垂体腺瘤内肾上腺皮质细胞的来源仍未得到解释。SF-1 在垂体和肾上腺皮质中的重要作用可能解释了一种支持鞍内未分化间充质干细胞异常增殖和分化的关系。然而，也有可能是胚胎发生过程中错位的肾上腺皮质细胞导致了这种罕见但独特的形态实体的产生，这可能会带来诊断上的困难。讨论了鉴别诊断的方法。
