常规病理检查未发现垂体腺瘤的Cushing病的临床与病理研究  

Cushing disease of no pituitary adenoma found in the routine pathological examination:a clinical and pathological study

作　　者：郭兰君[1] 任祖渊[1] 薛辉 臧旭[2] 

机构地区：[1]北京协和医院神经外科,100730 [2]北京协和医院病理科,100730

出　　处：《中华神经外科杂志》1993年第3期144-146,共3页Chinese Journal of Neurosurgery

摘　　要：从手术治疗136例 Cushing 病中选出常规病理检查未发现腺瘤的45例进临床及病理研究。发现45例中存在微腺瘤,11例未见腺瘤但有促肾上腺皮质激素(ACTH)细胞增生,另外17例仍未发现腺瘤或增生。ACTH 细胞增生主要为弥散性增生及节结性增生两种类型。腺瘤与增生二组病人术前的临床症状及内分泌检查结果无明显区别,但腺瘤病人手术效果较好,而增生组病人疗效较差,由于存在着瘤周围组织 ACTH 细胞增生或只见 ACTH 细胞增生,手术应切除瘤周围大部分垂体组织或行垂体次全切除术。Study of 45 cases with Cushing disease,but no pi-tuitary adenoma found in the routine pathological ex-amination.These cases were selected from 136 casestreated by transsphenoidal microsurgery for Cushingdisease.For further observation,all the resected pitu-itary tissues were embedded in paraffin,cut by serialsections and stained with hemayoxylin-eosin.For thedoubtful lesion,PAS and immunohistochemical PAStechniques(anti-ACTH,GH,PRL)were used.Among these 45 cases,we found 17 cases withmicroadenoma,11 cases with ACTH cell hyperplasiaand another 17 cases neither adenoma nor hyperplasia.We recognized that pituitary ACTH cell hyperplasiacould be diffuse or nodular in form.There were no ob-vious differences in the clinical and preoperative en-docrinal values between the patients with adenoma andthose with hyperplasia.The rate of remission washigher in patients with microadnoma than those withhyperplasia.During the operation,we could not differ-entiate the ACTH cell hyperplasia.Therefore we sug- gest to resect the pituitary tumor together with thesurrouding tissue or make a subtotal or total hypophy-sectomy.

关 键 词：CUSHING病 垂体肿瘤 显微外科学 

分 类 号：R736.4[医药卫生—肿瘤]