Saeger W
Fortschr Med. 1977 Jun 9;95(22):1458-62.
Pituitary adenomas should be classified by the grade of differentiation in undifferentiated (acidophil or mucoid cell type) and in highly differentiated types. Corresponding to their structural identify, the latter are separated into GH cell-, prolactin cell-, TSH cell-, or ACTH cell-adenomas. Chromophobe adenomas which are nearly ungranulated tumors, were divided into small cell- and large cell-adenomas and into oncocytic adenomas. Undifferentiated acidophil and GH cell-adenomas mostly induce an acromegaly. Undifferentiated mucoid and ACTH cell-tumors result exclusively in a hyperfunction of ACTH. The morphological correlate of a hyperprolactinemia is variable. Chromophobe adenomas of small cell type and oncocytic adenomas are on the whole endocrinologically inactive. Studies of the paraadenomatous adenohypophysis let us assume that prolactin cell- and ACTH cell-adenomas develop from hyperplasias of the specific cells. In animal experiments, pituitary adenomas can be classified into highly differentiated (prolactin cell-, TSH cell-, or ACTH cell-adenomas) and also into undifferentiated adenomas. The highly differentiated ones develop hyperplasiogenic and are monohormonally active. They are on the whole structurally identical with the human adenomas. The undifferentiated ones are the consequence of a process of dedifferentiation. They show in part a plurihormonal activity.
垂体腺瘤应根据未分化型(嗜酸性或黏液样细胞类型)和高分化型的分化程度进行分类。根据其结构特征,后者可分为生长激素(GH)细胞腺瘤、催乳素细胞腺瘤、促甲状腺激素(TSH)细胞腺瘤或促肾上腺皮质激素(ACTH)细胞腺瘤。嫌色性腺瘤几乎是无颗粒的肿瘤,可分为小细胞型和大细胞型腺瘤以及嗜酸性细胞瘤。未分化的嗜酸性细胞腺瘤和GH细胞腺瘤大多导致肢端肥大症。未分化的黏液样细胞和ACTH细胞肿瘤仅导致ACTH功能亢进。高催乳素血症的形态学关联是可变的。小细胞型嫌色性腺瘤和嗜酸性细胞瘤总体上内分泌无活性。对腺瘤旁腺垂体的研究使我们推测,催乳素细胞腺瘤和ACTH细胞腺瘤由特定细胞的增生发展而来。在动物实验中,垂体腺瘤可分为高分化型(催乳素细胞腺瘤、TSH细胞腺瘤或ACTH细胞腺瘤)和未分化腺瘤。高分化型腺瘤具有增生性且单激素活性。它们总体上与人类腺瘤在结构上相同。未分化型腺瘤是去分化过程的结果。它们部分表现出多激素活性。