18例垂体细胞瘤的临床病理特点分析

Clinicopathological analysis of 18 cases pituicytoma

目的提高对垂体细胞瘤的病理形态学、免疫表型、分子病理、临床治疗的认识。方法回顾性分析位于鞍内或鞍上的18例垂体细胞瘤患者临床病理资料并复习相关文献,其中男女各9例,年龄11~69岁,中位年龄44岁。免疫组化观察CK、EMA、Vim、S-100、GFAP、TTF-1、CD56、Syn、CgA、Ki-67表达情况。结果肿瘤细胞呈双极性梭形或纺锤状,弥漫性纤维束状、漩涡状或席纹状排列,肿瘤细胞界限不清,小核仁或未见核仁,未见核分裂。肿瘤细胞核弥漫性强阳性表达TTF-1、Vim、S-100,灶状胞浆表达EMA,弱表达GFAP,阴性表达CK、CD56、Syn、CgA;Ki-67增殖指数1%~5%。结论垂体细胞瘤是鞍区低级别胶质细胞瘤,发病年龄广泛,病理组织形态学包括梭形和上皮样两种亚型,双极性梭形为主,瘤细胞核弥漫性强表达基底前脑相关肿瘤标记TTF-1,首选手术治疗,不完全切除有复发可能。

Objective To improve the understanding of the pathomorphology,immunophenotype,molecular pathology and clinical treatment of pituicgtoma.Methods The clinicopathological data of 18 cases of pituicytoma located in sella or suprasella were retrospectively analyzed.There were 9 males and 9 females,aged from 11 to 69 years,with a median age of 44 years.The expressions of CK,EMA,Vim,S-100,GFAP,TTF-1,CD56,Syn,CgA,and Ki-67 were detected by immunohistochemistry.Results The cells of pituicytoma were bipolar spindle or spindle,diffuse fibrous bundle,whirlpool or mat like arrangement.The cells presented unclear boundaries,small nucleoli or no nucleoli,and no mitosis.TTF-1,Vim and S-100 were diffusely and strongly expressed in tumor nuclei,EMA was expressed in focal cytoplasm,GFAP was weakly expressed,and CK,CD56,Syn and CgA were negatively expressed,Ki-67 proliferation indexes were 1%-5%.Conclusion Pituicytoma is a low-grade glioma of the sellar area,with a wide age of onset.The pathological types include spindle and epithelioid.Most cells of pituicytoma are bipolar spindle,and the nuclei express TTF-1 diffusely.Surgical treatment is the first choice.Incomplete resection may lead to recurrence.