【摘要】 目的探讨垂体腺瘤合并神经胶质肿瘤的发生机制、临床病理学特征、诊断及鉴别诊断。方法复习8例垂体腺瘤合并神经胶质肿瘤患者的临床资料,并对其进行组织学和免疫组化(SP或EnVision法)标记观察。结果8例患者均为女性,年龄10~35岁,平均25.25岁。临床上7例患者有内分泌症状。组织学上肿瘤由两种不同形态组成,一部分肿瘤由大小较一致的圆形或卵圆形瘤细胞组成,其胞质丰富,嗜酸性或空淡,间质血窦丰富;另一部分肿瘤细胞呈梭形或星形,排列成条束状,核卵圆形或细长,可见微囊结构,间质小血管较丰富,部分梭形或星形肿瘤细胞中有散在或聚集的单核或双核异型神经节细胞。免疫组化标记8例圆形肿瘤细胞表达PrL、GH等垂体腺瘤标记物;而梭形肿瘤细胞GFAP(+),异型的神经节细胞Syn(+)。结论垂体腺瘤合并神经胶质肿瘤是一种发生在鞍区极为罕见的混合性良性肿瘤,其组织发生可能为垂体前叶腺细胞或垂体后叶神经胶质细胞发生肿瘤后,通过诱导刺激后叶神经胶质细胞或前叶腺细胞增生发生第二种肿瘤。该病的诊断主要依靠组织学和免疫组织化学。治疗以单纯手术切除为主,预后良好。更多还原

【Abstract】 Objective To investigate the pathogenes,clinicopathologic characteristics,diagnosis and differential diagnosis of the pituitary adenoma combined with astrocytoma/ganglioglioma.Methods Eight cases of pituitary adenoma combined with astrocytoma/ganglioglioma were stuided by clinical data analysis,histopathology and immunohistochemistry(SP or EnVision method).Results All the patients were female,with age ranged from 10 to 35 years(average 25.25 years).Clinically,seven patients presented with endocrinological symptoms.Microscopically,the tumor consisted of two structures: some tumors were spindle cells with round-oval to elongated-irregular nuclei which arranged in storiform pattern and interlacing fascicles;others were similar cells in size and shapes,with round-oval nuclei,abundant and acidophilic or pale cytoplasma.Immunohistochemically,spindle cells were positive for GFAP,ganglionic cells were positive for Syn,while the round cells were immunoreactive for PrL or GH.Conclusions Pituitary adenoma combined with astrocytoma/ganglioglioma is a very rare mixed pituitary tumor with good prognosis.The pathogenesis may be that the first tumor arising from neuroepithelial/glial cells of lobe posterior or endrocrine cells of anterior lobe pituitary stimulates the above cells proliferation,and results in the second tumor subsequently.The diagnosis of pituitary adenoma combined with astrocytoma/ganglioglioma depends mainly on histopathology as well as immunohistochemical staining.更多还原