临床与实验病理学杂志2024，Vol.40Issue(5)：490-496,7.DOI:10.13315/j.cnki.cjcep.2024.05.009
同时性多发性垂体神经内分泌肿瘤13例临床病理学分析
Multiple synchronous pituitary neuroendocrine tumors(PitNETs):a clinicopathological analysis of thirteen cases
摘要
Abstract
Purpose To investigate the cell components in different tumor lineages of multiple synchronous pituitary neuro-endocrine tumors(PitNETs)/neuroendocrine tumors(MSPs)and to carry out accurate histological typing,which provides an important basis for determining the follow-up plan and adjuvant therapy after surgery.Methods The clinical data of 855 pa-tients with PitNETs were collected and reclassified according to the new WHO standard.The clinicopathological features of 13 patients diagnosed as MSPs were analyzed retrospectively.The immunohistochemical EnVision two-step method was used to de-tect the expression of PIT-1,SF-1,T-PIT,GH,PRL,TSH,LH,FSH,ACTH,etc.,and related literatures were reviewed.Methods A total of 855 cases of pituitary neuroendocrine tumor from the second hospital of the Chinese Hebei Medical U-niversity were collected and reclassified according to the new WHO standard,and review the literature.Results(1)The age of patients were 39-68 years with median age of 55 years.7 cases were female and 6 were male;(2)Imaging findings:There was 1.2～3.8 cm(mean 2.5 cm)in maximum tumor di-ameter.13 patients were large adenomas,neither MSPs nor sin-gle lineage PitNETs could not assessed on imaging;(3)Clinical manifestations:3 cases had hyperprolactinemia which all contai-ning PitNETs components of PRL,one case was immature PIT-1 polyhormone cell tumor,one was dense granular prolactinoma,and one case was eosinophilic stem tumor.One patient had Cushing's disease and contained a Crook cell tumor component;two had elevated ACTH,and one had an adrenocorticotropic ad-enomatous component.In the two patients with no evidence of hormone excess,all contained gonadotropin cell tumor compo-nents;(4)Combination form:11 cases of the combination of the two cell lineages(5 cases of combination of SF-1 lineage and PIT-1 lineage;4 cases of combination of T-PIT lineage and PIT-1 lineage;1 case of null cell tumor and PIT-1 lineage;1 case of plurihormonal PitNETs and SF-1 lineage);Two cases of three cell combinations(null cell tumor,PIT-1 lineage,and T-PIT lineage);Among them,13 cases were PIT-1 lineage tumors,46.2％(6/13)were gonadotropin cell tumor,38.5％(5/13)were prolactinoma;(5)The presence of high-risk lineage tumors in the 10 patient combinations:3 immature PIT-1-lineage tumor,1 Crooke cell PitNETs,1 acidophil stem cells tumor,3 zero-cell PitNETs,and 4 silent-type sparse granular adrenocorti-cotropic hormone PitNETs;Two of them were combinations of two high-risk subtypes.Conclusion MSPs in our center are large adenomas,although their incidence is only 1.5％of Pit-NETs,2/3 cases have high-risk lineage tumor components,and the use of pituitary cell lineage transcription factors and adeno-hypophyseal hormones plays an important role in distinguishing and clarifying the different components of MSPs.关键词
垂体内分泌肿瘤/同时性多发性神经内分泌肿瘤/PIT-1谱系肿瘤/T-PIT谱系肿瘤/SF-1谱系肿瘤Key words
pituitary adenoma/endocrine tumor/multiple syn-chronous PitNETs/PIT-1 lineage tumor/T-PIT lineage tumor/SF-1 lineage tumor分类
医药卫生引用本文复制引用
杜世璇,付雨桐,邵琪琪,郭文丽,郝增方,娄蕾,李月红..同时性多发性垂体神经内分泌肿瘤13例临床病理学分析[J].临床与实验病理学杂志,2024,40(5):490-496,7.基金项目
河北省政府资助临床医学优秀人才项目(ZF2024036)、河北省中央引导地方科技发展资金项目(236Z7747G)、河北省医学适用技术跟踪项目(GZ2021045) （ZF2024036）
