Saeger W
Institute für Pathologie und Neuropathologie der Universität Hamburg, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Deutschland.
Pathologe. 2016 May;37(3):230-7. doi: 10.1007/s00292-016-0164-x.
Inflammatory findings in the pituitary glands account for approximately 1 % of operations in the sellar region. Primary inflammation (e.g. lymphocytic and idiopathic granulomatous hypophysitis) have to be differentiated from secondary types (e.g. concomittant inflammation with Rathke's cleft cysts, craniopharyngiomas and germinomas) and involvement of the pituitary in generalized inflammation (IgG4-related disease, sarcoidosis and septicopyemia). Langerhans cell histiocytosis also has to be considered for the differential diagnostics. Lymphocytic hypophysitis shows lymphocytic infiltrations of varying density, predominantly of the T‑cell type. Granulomatous hypophysitis has the features of sarcoidosis and can only be diagnosed by exclusion of generalized sarcoidosis. Secondary hypophysitis has a mixed cell infiltration, especially by histiocytic infiltration and predominantly originates from ruptures or bleeding from Rathke's cleft cysts. The frequently very sparse remnants of cyst epithelium should be confirmed by pankeratin immunostaining.
垂体的炎症表现约占鞍区手术的1%。原发性炎症（如淋巴细胞性和特发性肉芽肿性垂体炎）必须与继发性类型（如伴有拉克氏囊肿、颅咽管瘤和生殖细胞瘤的炎症）以及垂体在全身性炎症（IgG4相关疾病、结节病和败血病）中的受累情况相鉴别。朗格汉斯细胞组织细胞增多症在鉴别诊断中也必须予以考虑。淋巴细胞性垂体炎表现为密度各异的淋巴细胞浸润，主要为T细胞类型。肉芽肿性垂体炎具有结节病的特征，只能通过排除全身性结节病来诊断。继发性垂体炎有混合性细胞浸润，尤其是组织细胞浸润，主要起源于拉克氏囊肿的破裂或出血。囊肿上皮细胞常常非常稀少的残余部分应通过全角蛋白免疫染色来确认。
