Sautner D, Saeger W, Lüdecke D K
Department of Pathology of the Marienkrankenhaus, Hamburg, Germany.
Exp Clin Endocrinol. 1993;101(5):283-9. doi: 10.1055/s-0029-1211245.
In the sellar region most tumors of our collection (n = 1937) are pituitary adenomas, followed by craniopharyngiomas, chordomas and meningiomas. Difficulties in morphological differential diagnosis by light microscopy may occur in meningiomas, plasmacytomas, chordomas and germinomas. In these cases, immunohistological investigations and sometimes even electron microscopy are helpful in solving the problems. Meningiomas can sometimes resemble pituitary adenomas. Of diagnostic value in these cases is the expression of vimentin and S-100-protein in the meningioma cells. Plasmacytomas may also mimic pituitary adenomas. In these cases, the positive reaction with antibodies against LCA and immunoglobulins or against kappa-light-chains and lambda-light-chains leads to the diagnosis. Chordomas, too, can sometimes be hardly distinguished from pituitary adenomas. In these cases, the expression of S-100-protein, vimentin and CEA by the chordoma cells and the typical electron microscopic features of chordomas are helpful for the differential diagnosis. Germinomas may sometimes be indistinguishable from lymphocytic hypophysitis. Of diagnostic importance are here the expression of HCG and placental alkaline phosphatase by germinoma cells. In the above mentioned cases, it is also important to perform immunohistochemical examinations for pituitary hormones including alpha-subunit. All these tumors do not express these hormones.
在鞍区，我们收集的大多数肿瘤（n = 1937）是垂体腺瘤，其次是颅咽管瘤、脊索瘤和脑膜瘤。脑膜瘤、浆细胞瘤、脊索瘤和生殖细胞瘤在光镜下进行形态学鉴别诊断可能存在困难。在这些情况下，免疫组织学检查甚至有时电子显微镜检查有助于解决问题。脑膜瘤有时可能类似于垂体腺瘤。在这些病例中，波形蛋白和S - 100蛋白在脑膜瘤细胞中的表达具有诊断价值。浆细胞瘤也可能模仿垂体腺瘤。在这些情况下，针对LCA和免疫球蛋白或κ轻链和λ轻链的抗体呈阳性反应可做出诊断。脊索瘤有时也很难与垂体腺瘤区分开来。在这些情况下，脊索瘤细胞中S - 100蛋白、波形蛋白和CEA的表达以及脊索瘤典型的电子显微镜特征有助于鉴别诊断。生殖细胞瘤有时可能与淋巴细胞性垂体炎难以区分。在此，生殖细胞瘤细胞中HCG和胎盘碱性磷酸酶的表达具有诊断重要性。在上述病例中，对包括α亚基在内的垂体激素进行免疫组化检查也很重要。所有这些肿瘤均不表达这些激素。
