Neuronal metaplasia: A pituitary adenoma with gangliocytic component and growth hormone (GH) secretion
Notice bibliographique
Résumé
Background Pituitary adenomas (PA) possessing neuronal components are rare. These tumors are usually benign and arise within the sellar region. Most are associated with acromegaly and few with Cushing disease or hyperprolactinemia. Few studies have focused on the origin and presence of neuronal components in the sellar region. Clinical case A 53‐year‐old woman developed headaches and numbness on one side of her face. Initial work‐up found significant enlargement and/or elongation over the past five years to her hands, feet and face, along with blurred/double vision. She had a history of hypertension, polyuria, and polydypsia. MRI revealed a sellar/suprasellar mass extending toward the cavernous regions and into the chiasm. The lesion was interpreted as a pituitary macroadenoma with mass effect on the optic chiasm and optic nerves. Based on the clinical and radiologic findings, she was diagnosed with acromegalic features secondary to macroadenoma and was started on Octreotide. One month after starting drug treatment the patient underwent transsphenoidal surgery. Morphologic examination of the tissue revealed a homogenous population of predominantly acidophilic tumor cells with focal chromophobic cells. The tumor was admixed with ganglion cells with acidophilic cytoplasm, embedded in fibrillar, neuropil‐like matrix. Immunohistochemistry (IHC) of the tumor, showed intense positivity for GH. Cytokeratin immunostaining showed a distinct pattern of spherical paranuclear fibrous bodies in most cells. Multiple focal areas of neuropil populated with multi‐nucleated Nissl stained ganglion cells were noted. IHC showed that the ganglion cells expressed Hu, as well as variable immunopositivity for multiple pituitary hormones. The neuropil was also positive for neurofilament protein. Microscopic evaluation of the histologic and IHC findings, along with ultrastructural analysis, were characteristic of a sparsely granulated GH‐producing PA with a neuronal component corresponding to neuronal metaplasia. Conclusion At present, this entity is classified as “ganglicytoma” by the WHO. The name PA with neuronal metaplasia is a more appropriate designation than the other terminologies currently used. Analysis of published data is indicative that such a lesion is likely to have developed from uncommitted progenitor cells within the PA. Metaplasia best explains the presence of transitional cell types as indicated by the histological presence of NFP, Hu, and Nissl with production of multiple pituitary hormones in our sparsely granulated GH‐producing PA. The neuropil herein must have formed from a defective progenitor cell existing within the pituitary tissue. The exact relationship between GH‐producing PAs and the presence of neuronal cells within it is perplexing. The pathogenesis and nosology of PA with neuronal components is not yet fully resolved and further study is necessary to explore the cause, progression and influencing factors of this disease. Support or Funding Information This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».