腺垂体梭形细胞嗜酸细胞瘤临床病理观察

目的探讨腺垂体梭形细胞嗜酸细胞瘤的临床病理特征、诊断及鉴别诊断要点。方法对1例鞍区腺垂体梭形细胞嗜酸细胞瘤的临床表现、影像学特征、组织形态学、免疫表型及超微结构进行分析，并复习相关文献。结果患者女性，26岁。视力下降3年，停经2年半。影像学提示鞍区占位，术前拟诊为“脑膜瘤”。光镜下梭形肿瘤细胞呈束状或不规则排列，胞质丰富，嗜酸性，局部区域明显黏液变性，间质散在或小灶性淋巴细胞浸润。肿瘤细胞vimentin、S-100和EMA（＋），Ki-67标记指数〈1％。电镜下以瘤细胞胞质内大量肿胀的线粒体为特征，缺乏分泌颗粒。结论腺垂体梭形细胞嗜酸细胞瘤是罕见的鞍区肿瘤之一，应与鞍区的其他梭形细胞肿瘤相鉴别，熟悉其临床病理特征，依靠免疫组化和电镜可确诊。

Spindle cell oncocytoma of adenohypophysis: a clinicopathological observation

Objective To study the clinicopathological features and differential diagnosis of spindle cell oncocytoma of the adenohypophysis. Methods The clinical manifestations, radiologic and histopathological features,immunophenotype and ultrastructure were analyzed in one case of spindle cell oncocytoma of the adenohypophysis, with review of the related literatures. Results A 26 year-old- woman presented with 3 years history of downgrading of her vision and 2 years history of menolipsis. Image analysis showed a well-demarcated mass at the sellar region. Preoperational diagnosis was meningioma. Microscopically, The tumor was mainly composed of spindle cells arranged in fascicularis or irregularity. Neoplastic cells had eosinophilic, finely granular cytoplasm. The stroma was focally myxiod with a moderate lymphocytic infiltrate. Tumor cells were immunoreactive to vimentin, S-100 and EMA. Ultrastructurally, tumor cells were packed with swollen mitochondria. Conclusion Spindle cell oncocytoma of the adenohypophysis is a rare tumor and should be differentiated from the other spindle cell tumors in the sellar region. To be familiar with its clincopathological features and making good use of immunohistochemistry and electronic microscopy may help for correct diagnosis.