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鞍区涎腺样肿瘤。

Salivary gland-like tumors of the sellar region.

作者信息

Hampton T A, Scheithauer B W, Rojiani A M, Kovacs K, Horvath E, Vogt P

机构信息

Department of Pathology, University of Florida College of Medicine, Gainesville 32610-0275, USA.

出版信息

Am J Surg Pathol. 1997 Apr;21(4):424-34. doi: 10.1097/00000478-199704000-00008.

Abstract

Herein we present a group of rare tumors of the sella region that have not been previously recognized. Although clinically and radiographically the tumors resemble nonfunctioning pituitary adenomas, their histologic, immunohistochemical, and ultrastructural features differ and indicate a salivary gland origin. The lesions cover a morphologic spectrum that includes cellular pleomorphic adenoma, monomorphic adenoma, oncocytoma, and low-grade adenocarcinoma of the salivary gland. All tumors except the oncocytoma were immunoreactive for cytokeratin and were negative for pituitary hormones and synaptophysin. Ultrastructural characteristics in the cases examined include hypodense stromal material, basal lamina, and tonofilament bundles. The single oncocytoma was packed with mitochondria and lacked membrane-bound secretory granules. DNA ploidy based on image analysis and MIB-1 labeling indices showed diversity within this group of tumors, with labeling indices ranging from 0.06% to 15%. The presumed origin of these rare neoplasms is from salivary gland rests related to the normal pituitary gland. Despite their varied morphology, such tumors are easily confused with pituitary adenoma. Although rare, tumors of salivary gland origin should be considered in the differential diagnosis of unusual adenohypophyseal tumors.

摘要

在此,我们展示了一组以前未被认识的蝶鞍区罕见肿瘤。尽管在临床和影像学上这些肿瘤类似于无功能垂体腺瘤,但其组织学、免疫组化和超微结构特征不同,提示其起源于涎腺。这些病变涵盖了一系列形态学类型,包括细胞性多形性腺瘤、单形性腺瘤、嗜酸性细胞瘤和涎腺低级别腺癌。除嗜酸性细胞瘤外,所有肿瘤细胞角蛋白免疫反应阳性,垂体激素和突触素免疫反应阴性。所检查病例的超微结构特征包括低密度间质物质、基膜和张力丝束。唯一的嗜酸性细胞瘤充满线粒体,缺乏膜结合分泌颗粒。基于图像分析的DNA倍体和MIB-1标记指数显示这组肿瘤具有多样性,标记指数范围为0.06%至15%。这些罕见肿瘤的推测起源是与正常垂体相关的涎腺残余组织。尽管它们形态各异,但此类肿瘤很容易与垂体腺瘤混淆。尽管罕见,但在鉴别诊断不寻常的腺垂体肿瘤时应考虑涎腺起源的肿瘤。

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