Lindholm J, Bjerre P, Riishede J, Gyldensted C, Hagen C
Clin Endocrinol (Oxf). 1983 Jun;18(6):599-603. doi: 10.1111/j.1365-2265.1983.tb00597.x.
Forty-four untreated patients with an enlarged sella were studied (excluding patients with acromegaly, Cushing's disease, and those with radiological evidence of suprasellar extension). In 20 patients CT revealed a completely or partially empty sella. Based on recent studies we take this finding to signify the previous presence of a pituitary adenoma which has undergone complete or partial necrosis. Ten of the 20 patients had in fact experienced symptoms typical of a pituitary apoplexy compared with only one out of the other 24 patients. Adrenal, thyroid, and growth-hormone insufficiency occurred as often in patients with an empty sella as in those with a solid pituitary tumour. In contrast, plasma prolactin levels were much lower in patients with an empty sella than in patients with a solid tumour (11 vs 166 ng/ml). It is assumed that this discrepancy reflects previous necrosis occurring in an adenoma hypersecreting prolactin. These results emphasize the importance of taking the spontaneous course of pituitary adenomas into account when assessing the effect of various treatment protocols.
对44例未经治疗的蝶鞍扩大患者进行了研究（不包括肢端肥大症、库欣病患者以及有鞍上扩展影像学证据的患者）。20例患者的CT显示蝶鞍完全或部分为空。根据最近的研究，我们认为这一发现表明先前存在垂体腺瘤，该腺瘤已发生完全或部分坏死。20例患者中有10例实际上出现了垂体卒中的典型症状，而其他24例患者中只有1例出现此类症状。空蝶鞍患者出现肾上腺、甲状腺和生长激素功能不全的频率与实性垂体肿瘤患者相同。相比之下，空蝶鞍患者的血浆催乳素水平远低于实性肿瘤患者（分别为11 ng/ml和166 ng/ml）。据推测，这种差异反映了先前在分泌催乳素的腺瘤中发生的坏死。这些结果强调了在评估各种治疗方案的效果时，考虑垂体腺瘤自然病程的重要性。
