伴有Rathke囊肿的垂体腺瘤临床病理观察

Pituitary adenomas accompanied by Rathke’s cleft cyst:a clinicopathologic analysis

目的报道伴有Rathke囊肿的垂体腺瘤,分析其临床病理特征。方法对2例伴Rathke囊肿的垂体腺瘤进行组织病理学和免疫组化研究,结合文献对其临床表现、组织病理学特征和组织学来源进行讨论。结果2例伴Rathke囊肿垂体腺瘤中肿瘤细胞呈多边形,胞质丰富透亮,核圆,大小一致,排列呈巢状及片状,间质内见血窦。瘤组织中央见一囊,内衬单层纤毛柱状上皮。免疫组化：例1瘤细胞FSH（＋）,囊壁上皮细胞CK、EMA和AB-PAS（＋）。结论伴有Rathke囊肿的垂体腺瘤非常罕见,明确诊断依赖于组织病理学观察及免疫组化标记。

Objective To report 2 cases of pituitary adenomas accompanied by Rathke＇s cleft cyst, and to discuss its clinicopathologic features. Methods Histological observation and immunohistochemical studies were conducted in 2 cases of pituitary adenomas accompanied by Rathke＇s cleft cyst, and it＇s clinical findings, histopathologic features and treatment were discussed in combination with review of the literature. Results The tumor cells were polygonal with clear and abundant cytoplasm and uniform and round nucleus, and arranged in nests and sheets patterns with irregular blood sinusoids in the stroma. A cyst located in the center of the tumor and lined by simple ciliated columnar epithelial cells. Immunohistochemical stains showed that tumor cells were positive for FSH in one case, and LH, TSH, ACH-I, GH, GFAP and S-100 were negative. The epithelial cells of the cleft were positive for CK, EMA and AB-PAS. Conclusion Pituitary adenoma accompanied by Rathke＇s cleft cyst is a very rare disease. The diagnosis mainly relies on histopathology and immanohistochemistry.