垂体细胞瘤临床病理观察

Clinicopathologic analyses of pituicytoma

目的探讨垂体细胞瘤的临床病理学特点及诊断要点。方法对2例垂体细胞瘤的临床资料、影像学、病理形态学及免疫组化结果进行分析,并结合文献探讨其诊断及鉴别诊断。结果 2例患者的头颅MRI提示鞍区占位。镜下可见短梭状双极梭形细胞成分,细胞密度较低,排列稀疏,呈纤维束状排列,细胞核圆形或伸长形,局部可见血管结构,未见核分裂。免疫组化:vimentin、S-100和GFAP均(+)、Ki-67增殖指数<1%,NEU-N和EMA均(-)。结论垂体细胞瘤起源于成人神经垂体或漏斗,较为罕见,由梭形细胞构成,生长缓慢,需与正常漏斗组织、毛细胞星形细胞瘤、梭形嗜酸细胞瘤等进行鉴别诊断。

Objective To explore the clinical and pathological characteristics and diagnostic criteria of pituicytoma. Methods The clinical data, radiological, histopathologic changes and immunohistochemical staining were studied in 2 cases of pituicytoma; its diagnosis and differential diagnosis were discussed with review of the relevant literature. Results Case 1 was a 26-year-old female, and Case 2, a 25-year-old male. Cranial MRI showed an occupying lesion in saddle space. Microscopy showed a short bipolar spindle-like spindle cell component which had a lower cell density, sparse arrangement like glial fiber bundle and vascular structures were seen locally. No mitosis was found. Immunohistochemical staining showed that the tumors were positive for vimentin, S-100, GFAP, vimentin, and Ki-67 （ ＋ 〈 1% ）, but negative for NEU-N and EMA. Both of these cases were diagnosed as pituitary tumor, WHO grade I ~ Conclusion Pituicytoma originates in the adult pituitary or infundibulum. Pituicytoma is rare and composed of low-grade spindle ceils with slow growth. It is necessary to be differentiated from normal infundibulum tissue, pilocytic astrocytoma and spindle cell oncocytoma.