混合性神经节细胞瘤-垂体腺瘤4例临床病理特征分析及文献复习

Characteristics of mixed gangliocytoma-pituitary adenoma:a clinicopathological analysis of four cases and review of literature

目的 混合性神经节细胞瘤-垂体腺瘤的临床表现及影像学特点不典型,术前诊断容易误诊,需病理确诊,本文旨在总结其临床病理特征及预后,以提高对此疾病的认识。方法 回顾性分析空军军医大学西京医院病理科2009-01—2020-09诊断为混合性神经节细胞瘤-垂体腺瘤的病例共4例,分析其临床病理特征及预后并进行文献复习。结果 4例混合性神经节细胞瘤-垂体腺瘤患者男性2例、女性2例,年龄为49~59岁,平均年龄为54岁。组织学形态特点为肿瘤组织由两种不同的成分构成,一种为散在或不规则簇状排列的,分布于神经纤维背景中的神经节样细胞,细胞体积大,胞质嗜酸性,核仁明显,另一部分肿瘤细胞呈圆形,大小相对较一致,弥漫片状或腺样排列,两种成分常相互混杂。免疫组化染色神经节样细胞Syn、NeuN阳性,腺垂体激素阴性,圆形肿瘤细胞区域肿瘤细胞Syn阳性,部分病例GH阳性。结论 混合性神经节细胞瘤-垂体腺瘤是蝶鞍区较为少见的肿瘤,男女均可发生,常常合并肢端肥大症及激素异常,该肿瘤的诊断主要依靠组织病理学以及免疫组化协同诊断,治疗上采取手术切除,预后较好。

Objective To investigate the clinical manifestations,imaging changes,clinicopathological features,diagnosis and prognosis of mixed gangliocytoma-pituitary adenoma.Methods The clinical and imaging data of 4 patients with mixed gangliocytoma-pituitary adenoma were reviewed,and the histology(HE staining) and immunohistochemical staining were observed.Results Four patients with mixed gangliocytoma-pituitary adenoma were 2 males and 2 females,the age was 49-59 years,with average 54 years.The tumors were composed of two different types of cells:one was a ganglion cell,which was characterized by large cell volume and eosinophilic cytoplasm.Immunohistochemistry showed that the tumor cells expressed CGA and Syn,but not GFAP;another of the tumor cells were round and the size was relatively uniform,and the tumor cells expressed GH and PRO.Conclusion Mixed gangliocytoma-pituitary adenoma is a rare tumor in sella turcica region.It can occur in both sexes and is often associated with acromegaly and hormone abnormalities.The diagnosis of mixed gangliocytoma-pituitary adenoma mainly depends on the combined diagnosis of histopathology and immunohistochemistry,and the prognosis is better after surgical resection.