在皮质瘤PitNET中出现NEC特征:初级瘤,辐射诱导的转变或转移?
Naoko Inoshita1,2, Hiroshi Nishioka3, Noriaki Fukuhara3
1Department of Pathology, Toranomon Hospital, Tokyo, Japan. inonao3939@gmail.com.
Brain tumor pathology
|September 3, 2025
概括
两个罕见的垂体神经内分泌癌 (NEC) 病例表明放射治疗后皮质瘤的转变. 需要进一步调查以确认初级NEC或转移性疾病的起源.
科学领域:
- 内分泌学
- 癌症学
- 病理学
背景情况:
- 下垂体神经内分泌瘤 (PitNETs) 通常是良性的.
- 一种罕见的PitNETs可以表现出攻击性行为或恶性转变.
- 原发性垂体神经内分泌癌 (NEC) 异常罕见,其存在受到争议.
研究的目的:
- 报告两例具有新兴NEC特征的皮质菌.
- 研究放射治疗在NEC转化中的潜在作用.
- 讨论脑下垂体中初级与转移性NEC的差异诊断.
主要方法:
- 对两名患有库辛病的女性病例报告进行分析.
- 组织病理学检查包括ACTH,TPIT,p53和Ki-67的免疫组织化学检查.
- 临床病史,瘤特征和治疗反应,包括放射治疗.
主要成果:
- 在放射治疗后,两种皮质皮细胞转化为NEC组件.
- NEC组件显示高等级的特征:形,,高Ki-67,扩散p53,以及ACTH/TPIT降低.
- 病例2提出了诊断上的挑战,可能是原发性NEC或转移性疾病.
结论:
- 在皮质营养不良的PitNET中出现NEC特征可能是由于放射治疗后的转变.
- 在具有非典型特征的病例中,诊断不确定性仍然存在,需要考虑初级或转移性NEC.
- 这些发现强调了用放射治疗治疗下垂体瘤的警随访的重要性.
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