Hurley T R, D'Angelo C M, Clasen R A, Wilkinson S B, Passavoy R D
Division of Neurosurgery, Christ Hospital and Medical Center, Oak Lawn, Illinois.
Neurosurgery. 1994 Aug;35(2):314-7; discussion 317. doi: 10.1227/00006123-199408000-00021.
A case of a pituicytoma is presented that describes the clinical, pathological, and magnetic resonance imaging features of a rare tumor of the neurohypophysis. A 26-year-old woman presented with a 4-month history of dizziness and visual obscuration. A magnetic resonance image revealed a pituitary mass with suprasellar extension. The specimen obtained from a transsphenoidal decompression identified the mass as an astrocytoma of the posterior pituitary (pituicytoma). Immunohistochemical staining was positive for glial fibrillary acidic protein, S-100, and vimentin. Electron microscopy identified intermediate filaments, numerous broad cell junctions, no secretory granules, and two cellular populations with either an electron-dense or lucent cytoplasmic matrix. This case is unique in that other documented cases originating in the posterior pituitary have all been pilocytic astrocytomas, whereas this neoplasm was not a pilocytic variant. This is also the first case in the literature of a pituicytoma documented by magnetic resonance imaging. This report reviews the cytological elements of the neurohypophysis and the origin of pituicytomas and stresses the proper use of the term "pituicytoma" in relation to tumors of the posterior pituitary.
本文报告一例垂体细胞瘤,描述了一种罕见的神经垂体肿瘤的临床、病理及磁共振成像特征。一名26岁女性,有4个月的头晕和视力模糊病史。磁共振成像显示垂体肿块并向上延伸至鞍上。经蝶窦减压获取的标本显示该肿块为垂体后叶星形细胞瘤(垂体细胞瘤)。免疫组化染色胶质纤维酸性蛋白、S-100和波形蛋白呈阳性。电镜检查发现中间丝、大量宽阔的细胞连接、无分泌颗粒,以及两种细胞质基质分别为电子致密或透亮的细胞群。该病例的独特之处在于,其他文献记载的起源于垂体后叶的病例均为毛细胞型星形细胞瘤,而此肿瘤并非毛细胞型变体。这也是文献中首例经磁共振成像确诊的垂体细胞瘤。本报告回顾了神经垂体的细胞学成分及垂体细胞瘤的起源,并强调了“垂体细胞瘤”这一术语在垂体后叶肿瘤中的正确应用。