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猫垂体腺瘤:组织学和免疫组织化学特征与临床发现和病例结果的相关性。

Feline Pituitary Adenomas: Correlation of Histologic and Immunohistochemical Characteristics With Clinical Findings and Case Outcome.

机构信息

311308Purdue University, West Lafayette, IN, USA.

Comparative Biomedical Scientist Training Program, National Institutes of Health, Bethesda, MD, USA.

出版信息

Vet Pathol. 2021 Mar;58(2):266-275. doi: 10.1177/0300985820978309. Epub 2020 Dec 7.

Abstract

Pituitary glands from 141 feline autopsy cases were reviewed histologically. Adenoma and hyperplasia were the most common lesions at 13 cases each. Pituitary adenoma was more likely than hyperplasia to be associated with clinical evidence of endocrinopathy or an intracranial mass ( < .001). A histochemical and immunohistochemical panel was applied to 44 autopsy- or hypophysectomy-derived pituitary adenomas in 43 cats from 2 diagnostic laboratories. Adenomas were differentiated from hyperplasia by the presence of disrupted reticulin fibers. One cat had a double (somatotroph and melanotroph) adenoma. Twenty somatotroph adenomas consisted of periodic acid-Schiff (PAS)-negative acidophils that expressed growth hormone; 16/20 had hypersomatotropism; 17/20 had diabetes mellitus. Eleven melanotroph adenomas consisted of PAS-positive basophils or chromophobes that expressed melanocyte-stimulating and adrenocorticotrophic hormones; 5/11 had hypercortisolism; 6/11 had diabetes mellitus. Eleven gonadotroph adenomas consisted of PAS-negative chromophobes that expressed follicle-stimulating and/or luteinizing hormones. Two thyrotroph adenomas consisted of PAS-negative basophils or chromophobes that expressed thyroid-stimulating hormone. Pituitary-dependent disease was not recognized in cats with gonadotroph or thyrotroph adenomas. The Ki-67 proliferation index in hypophysectomy specimens was lower in somatotroph than in melanotroph adenomas. Fourteen cats with hypophysectomy-treated somatotroph or melanotroph adenoma had an 899-day median survival time versus 173 days in 17 nonsurgical cases. After adjusting for age, adenoma size and type, hypophysectomized cats had an overall better survival time than nonsurgical cases ( = .029). The study results underscore the value of hypophysectomy and trophic hormone immunohistochemistry in the treatment and classification of feline pituitary adenomas.

摘要

对 141 例猫尸检病例的垂体进行了组织学回顾。腺瘤和增生是最常见的病变,各有 13 例。与增生相比,垂体腺瘤更有可能与内分泌疾病或颅内肿块的临床证据相关(<.001)。在来自 2 个诊断实验室的 43 只猫的 44 例尸检或垂体切除术衍生的垂体腺瘤中应用了一组组织化学和免疫组织化学组合。通过破坏的网状纤维将腺瘤与增生区分开来。一只猫有一个双(生长激素和黑色素细胞刺激素)腺瘤。20 个生长激素腺瘤由过碘酸雪夫(PAS)阴性的嗜酸性粒细胞组成,表达生长激素;16/20 例存在高生长激素血症;17/20 例患有糖尿病。11 个黑色素细胞刺激素腺瘤由 PAS 阳性的嗜碱性粒细胞或嫌色细胞组成,表达黑色素细胞刺激素和促肾上腺皮质激素;5/11 例存在高皮质醇血症;6/11 例患有糖尿病。11 个促性腺激素腺瘤由 PAS 阴性的嫌色细胞组成,表达卵泡刺激素和/或黄体生成素。2 个促甲状腺素腺瘤由 PAS 阴性的嗜碱性粒细胞或嫌色细胞组成,表达促甲状腺激素。在患有促性腺激素或促甲状腺素腺瘤的猫中未发现垂体依赖性疾病。在接受垂体切除术的标本中,生长激素腺瘤的 Ki-67 增殖指数低于黑色素细胞刺激素腺瘤。在接受垂体切除术治疗的生长激素或黑色素细胞刺激素腺瘤的 14 只猫中,中位生存时间为 899 天,而 17 例未接受手术的病例为 173 天。在调整年龄、腺瘤大小和类型后,接受垂体切除术的猫的总体生存时间优于未接受手术的病例(=.029)。研究结果强调了垂体切除术和促激素免疫组织化学在猫垂体腺瘤的治疗和分类中的价值。

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