Kovacs K, Corenblum B, Sirek A M, Penz G, Ezrin C
J Clin Pathol. 1976 Mar;29(3):250-8. doi: 10.1136/jcp.29.3.250.
In order to identify prolactin-producing tumours in human pituitary glands, 45 chromophobe adenomas, obtained from unselected necropsies, have been studied by various staining procedures including the immunoperoxidase technique for the demonstration of prolactin. The presence of immunoreactive prolactin was revealed in the cytoplasm of the tumour cells in six cases (13%), indicating that the occurrence of prolactin-producing adenomas is not rare. No correlations were established between tumours and clinical history. Two adenomas were detected in female and four in male patients. The age of the patients at necropsy ranged from 28 to 75 years. Three adenomas were associated with disseminated carcinoma, two with fatal liver disease, and one with diabetes mellitus, atherosclerosis, and pyelonephritis. Manifest endocrine symptoms were not disclosed, and endocrine investigations, including measurements of blood prolactin levels, were not undertaken. Thus, direct evidence is lacking as to whether or not these tumours were actively secreting prolactin. In the non-tumorous parts of the anterior lobes the number of prolactin cells was decreased in two cases, suggesting that prolactin released from the adenoma cells suppressed prolactin production in the non-tumorous pituitary. However, the number of prolactin cells of the non-tumorous adenohypophysis seemed to be unchanged in two and increased in another two cases. The present findings conclusively proved the existence of the prolactin-producing adenomas as a distinct entity. These tumours do not stain with acid or basic dyes, they are PAS or thionin negative, and do not contain immunoreactive growth hormone. Thus, by conventional staining procedures they are indistinguishable from other chromophobe adenoma types. Herlant's erythrosin and Brookes' carmoisine methods, claimed spedifically to stain prolactin cells, failed to provide reliable results, hence their use cannot be recommended in tumour identification. Immunoperoxidase staining of prolactin is the only technique which conclusively reveals the presence of immunoreactive prolactin in the cytoplasm of the tumour cells and permits diagnosis. It is proposed that this technique be introduced in pituitary morphological studies. Its application may lead to a better understanding of problems related to prolactin-producing tumours and their secretory activity.
为了在人垂体中识别分泌催乳素的肿瘤，对45例从未经挑选的尸检中获得的嫌色性腺瘤采用了包括免疫过氧化物酶技术（用于显示催乳素）在内的各种染色方法进行研究。在6例（13%）肿瘤细胞的细胞质中发现了免疫反应性催乳素，这表明分泌催乳素的腺瘤并非罕见。肿瘤与临床病史之间未建立相关性。在女性患者中检测到2例腺瘤，男性患者中检测到4例。尸检时患者年龄在28至75岁之间。3例腺瘤与播散性癌相关，2例与致命性肝病相关，1例与糖尿病、动脉粥样硬化和肾盂肾炎相关。未发现明显的内分泌症状，也未进行包括血催乳素水平测定在内的内分泌检查。因此，缺乏这些肿瘤是否在积极分泌催乳素的直接证据。在前叶的非肿瘤部分，有2例催乳素细胞数量减少，提示腺瘤细胞释放的催乳素抑制了非肿瘤性垂体中催乳素的产生。然而，在另外2例中，非肿瘤性腺垂体的催乳素细胞数量似乎未变，还有2例增加。目前的研究结果确凿地证明了分泌催乳素的腺瘤作为一种独特实体的存在。这些肿瘤不被酸性或碱性染料染色，PAS或硫堇染色阴性，且不含有免疫反应性生长激素。因此，通过传统染色方法，它们与其他类型的嫌色性腺瘤无法区分。Herlant的伊红染色法和Brookes的卡红染色法据称可特异性地对催乳素细胞染色，但未能提供可靠结果，因此不建议在肿瘤识别中使用。催乳素的免疫过氧化物酶染色是唯一能确凿显示肿瘤细胞胞质中存在免疫反应性催乳素并允许诊断的技术。建议将该技术引入垂体形态学研究中。其应用可能有助于更好地理解与分泌催乳素的肿瘤及其分泌活性相关的问题。
