Barrande G, Kujas M, Gancel A, Turpin G, Bruckert E, Kuhn J M, Luton J P
Clinique des Maladies endocrimiennes et métaboliques, Hôpital Cochin, Paris.
Presse Med. 1995 Oct 14;24(30):1376-80.
Granular cell tumours of neurohypophysis are rare. These tumours are more often encountered as incidental autopsy findings seen in up to 17% of unselected adult autopsy cases. There are few reports of parasellar granular cell tumours large enough to cause symptoms. We present three cases of neurohypophysis granular cell tumour and a review of the literature. In one patient, the asymptomatic granular cell tumour was incidentally discovered at surgical removal of a corticotroph microadenoma. The remaining 2 patients had a symptomatic tumour which caused neurological symptoms such as visual disturbance and headaches and endocrine disorders such as hypopituitarism or hyperprolactinaemia. In these 2 cases, computerized tomography showed a well-circumscribed, contrast-enhanced, intrasellar and suprasellar mass. Magnetic resonance imaging demonstrated an isointense gadolinium-enhanced mass in T1-weighted images. Transsphenoidal partial resection was performed and histology was interpreted as a granular cell tumour. The immunohistochemical study was positive for glial fibrillary acidic protein (GFAP) and neuron specific enolase (NSE) in 1 of the 2 tumours and positive for S100 protein and vimentin in both tumours but negative for CD68. The histogenesis of neurohypophysis granular cell tumours is still controversial but ultrastructural and immunohistochemical studies support the theory that they may arise from pituicytes, the glial cells of neurohypophysis. Management of these benign, slow-growing, tumours is based mainly on neurosurgical resection. Data from the literature do not support a beneficial effect of postoperative radiation therapy on postoperative recurrences.
神经垂体颗粒细胞瘤很罕见。这些肿瘤更多是在偶然的尸检中发现，在高达17%的未选择的成人尸检病例中可见。关于鞍旁颗粒细胞瘤大到足以引起症状的报道很少。我们报告3例神经垂体颗粒细胞瘤并对文献进行综述。1例患者在手术切除促肾上腺皮质激素微腺瘤时偶然发现无症状的颗粒细胞瘤。其余2例患者有症状性肿瘤，引起视觉障碍和头痛等神经症状以及垂体功能减退或高泌乳素血症等内分泌紊乱。在这2例中，计算机断层扫描显示为边界清晰、有强化的鞍内和鞍上肿块。磁共振成像在T1加权图像上显示为等信号钆强化肿块。进行了经蝶窦部分切除术，组织学诊断为颗粒细胞瘤。免疫组化研究显示，2例肿瘤中的1例胶质纤维酸性蛋白（GFAP）和神经元特异性烯醇化酶（NSE）呈阳性，2例肿瘤中S100蛋白和波形蛋白均呈阳性，但CD68呈阴性。神经垂体颗粒细胞瘤的组织发生仍存在争议，但超微结构和免疫组化研究支持它们可能起源于垂体细胞（神经垂体的胶质细胞）这一理论。这些良性、生长缓慢的肿瘤的治疗主要基于神经外科手术切除。文献数据不支持术后放疗对术后复发有有益作用。
