【摘要】 目的探讨垂体瘤继发黄色肉芽肿的临床特征及诊断、治疗与预后。方法回顾性分析5例经手术治疗的垂体瘤继发黄色肉芽肿患者的临床资料;并结合文献分析其病理特点、发病机制、临床表现、影像学特征及治疗措施。结果术前MRI检查示2例患者垂体瘤内有T₁WI和T₂WI高信号。5例患者均行手术治疗,术中见瘤内有黄色液态内容物者2例,术后组织病理检查有含铁血黄素沉着3例;术后出现暂时性尿崩3例,对症治疗后症状改善,1例患者需长期激素替代治疗。结论不同程度垂体前叶功能减退是垂体瘤合并黄色肉芽肿的临床特点。MRI示垂体瘤在T₁WI和T₂WI均有高信号囊变灶要考虑垂体瘤继发黄色肉芽肿的可能;影像学和病理学检查发现有含铁血黄素提示黄色肉芽肿可能与垂体腺瘤的多次少量出血有关;手术治疗可获得良好的预后。更多还原

【Abstract】 Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of pituitary adenomas with xanthogranuloma.Methods The clinical data of 5 cases of pituitary adenomas with xanthogranuloma underwent operation were analyzed retrospectively,and the pathology,pathogenesis,clinical manifestations,imaging features and treatment of this entity were analyzed in combination with the literature.Results Preoperative MRI showed two patients had high signal on T₁WI and T₂WI in pituitary adenomas.All of the 5 patients underwent operation.Yellow liquid contents were found in 2 cases during operation,and hemosiderosis was found in 3 cases after operation.Temporary diabetes insipidus occurred in 3 cases after operation,and the symptoms were improved after symptomatic treatment.One patient needed long-term hormone replacement therapy.Conclusions Various degrees of anterior pituitary dysfunction is the clinical feature of pituitary adenomas with xanthogranuloma.The possibility of pituitary adenomas with xanthogranuloma should be considered when MRI suggests that pituitary adenomas present high signal cysts in both T₁WI and T₂WI.Imaging and pathology examination find the presence of hemosiderin suggests that xanthogranuloma may be associated with multiple minor bleeding events of pituitary adenomas.Surgical treatment can lead to a good prognosis.更多还原