激素表达差异性垂体癌

目的报告1例原位和转移灶激素表达差异的垂体癌患者的临床诊断与治疗经过,以提高对该病的认识。方法与结果女性患者,50岁。临床主要表现为垂体腺瘤切除术后4个月眼部胀痛不适。MRI显示颅内多发异常信号,垂体形态欠规则,鞍区呈异常信号和强化影;PET-CT显示多发高摄取病灶。首次术后HE染色,肿瘤细胞弥漫性分布,呈圆形或多边形伴轻度异形,胞质中等量、嗜酸性,胞核圆形、染色质较细、核仁不明显,核分裂象易见,无坏死;免疫组织化学染色,肿瘤细胞分别表达P53、嗜铬素A,个别表达生长激素,Ki-67抗原标记指数约为80%,病理诊断为非典型垂体腺瘤。肿瘤复发转移后顶叶肿瘤活检术可见肿瘤浸润脑实质,肿瘤细胞弥漫表...

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Published in中国现代神经疾病杂志 Vol. 15; no. 1; pp. 57 - 62
Main Author 鲁涛 王任直 朱朝晖 钟定荣
Format Journal Article
LanguageChinese
Published 100730,中国医学科学院北京协和医学院北京协和医院病理科%100730,中国医学科学院北京协和医学院北京协和医院神经外科%100730,中国医学科学院北京协和医学院北京协和医院核医学科 2015
Subjects
体层摄影术,发射型计算机
免疫组织化学
垂体肿瘤
激素类
病理学
Immunohistochemistry
Pathology
Pituitary neoplasms
体层摄影术,发射型计算机
垂体肿瘤
激素类
Hormones
免疫组织化学
病理学
Tomography,emission-computed
Online AccessGet full text
ISSN1672-6731
DOI10.3969/j.issn.1672-6731.2015.01.013

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Summary:目的报告1例原位和转移灶激素表达差异的垂体癌患者的临床诊断与治疗经过,以提高对该病的认识。方法与结果女性患者,50岁。临床主要表现为垂体腺瘤切除术后4个月眼部胀痛不适。MRI显示颅内多发异常信号,垂体形态欠规则,鞍区呈异常信号和强化影;PET-CT显示多发高摄取病灶。首次术后HE染色,肿瘤细胞弥漫性分布,呈圆形或多边形伴轻度异形,胞质中等量、嗜酸性,胞核圆形、染色质较细、核仁不明显,核分裂象易见,无坏死;免疫组织化学染色,肿瘤细胞分别表达P53、嗜铬素A,个别表达生长激素,Ki-67抗原标记指数约为80%,病理诊断为非典型垂体腺瘤。肿瘤复发转移后顶叶肿瘤活检术可见肿瘤浸润脑实质,肿瘤细胞弥漫表达生长激素,Ki-67抗原标记指数约为75%,病理诊断为转移性垂体癌。结论垂体癌为临床罕见的恶性垂体肿瘤,需结合影像学和术后组织病理学明确诊断。首选外科手术切除肿瘤灶,辅助术后放射治疗或药物化疗,患者多预后不良。
Bibliography:Pituitary neoplasms; Hormones; Tomography; emission-computed; Immunohistochemistry; Pathology
Objective To introduce the experience of diagnosing and treating one case of pituitarycarcinoma with distinct hormone expressions in primary and metastatic lesions and to improveunderstanding of this disease.Methods Retrospective study was performed to analyze the clinical manifestations, imaging characteristics, histopathologic findings, and treatment information of the patient.Immunohistochemical staining was done to both primary and metastatic lesions.Results The patientpresented with eye pain and discomfort 4 months posterior to pituitary adenoma surgery. Head MRI showedmultiple abnormal intracranial signals, irregular pituitary contour, and abnormal enhancements of the sellarregion. PET-CT scan showed multiple hypermetabolic lesions. After the first surgery, histological study of the pituitary tumor showed disseminated tumor cells. The cells were round-shaped or polygonal, with mildatypia, moderate amount of eosi
ISSN:1672-6731
DOI:10.3969/j.issn.1672-6731.2015.01.013