Kim Dong Ja, Lee SangHan, Kim Mee-Seon, Hwang Jeong-Hyun, Hahm Myong Hun
Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Forensic Medicine, Defense Institute of Forensic Science, Seoul, Korea.
J Pathol Transl Med. 2021 May;55(3):225-229. doi: 10.4132/jptm.2021.01.27. Epub 2021 Mar 9.
We present a rare case of spindle cell oncocytoma (SCO) of the sella turcica with malignant histologic features and rapid progression. A 42-year-old woman experienced bilateral blurred vision and was preoperatively misdiagnosed as having a pituitary macroadenoma on magnetic resonance imaging. After surgery, SCO was diagnosed by the histopathologic features of interlacing fascicles of spindle tumor cells with finely granular, eosinophilic cytoplasm. Focal anaplastic changes and necrosis were present. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, S-100, galectin-3, and thyroid transcription factor 1. Four months later, the tumor had progressed, and second surgery with adjuvant radiotherapy was performed; the patients remains under observation. In this report, we proposed distinctive radiologic features for differential diagnosis between SCO and other pituitary tumors.
我们报告一例罕见的蝶鞍区具有恶性组织学特征且进展迅速的梭形细胞嗜酸细胞瘤（SCO）。一名42岁女性出现双侧视力模糊，术前磁共振成像被误诊为垂体大腺瘤。术后，根据梭形肿瘤细胞交织束状结构、细胞质细腻颗粒状且嗜酸性的组织病理学特征诊断为SCO。存在局灶间变改变和坏死。免疫组化显示，肿瘤细胞波形蛋白、上皮膜抗原、S-100、半乳糖凝集素-3和甲状腺转录因子1呈阳性。四个月后，肿瘤进展，进行了二次手术及辅助放疗；患者仍在观察中。在本报告中，我们提出了SCO与其他垂体肿瘤鉴别诊断的独特影像学特征。
