经蝶窦选择性切除垂体ACTH微腺瘤治疗Cushing病

本文报告了1981年6月～1985年3月间经蝶窦选择性切除垂体ACTH微腺瘤治疗28例Cushing病的经验,包括3例因蝶鞍环窦解剖学异常未能作垂体探查。25例作了垂体瘤切除术,取得良好效果。有效率为84％(21例),其中优良级17例(68％);减轻4例(16％),无效2例(8％),复发2例(8％)。无死亡.组织学发现垂体源ACTH腺瘤88％(22例)。本文还讨论了诊断、手术适应症、影响手术疗效的因素和手术并发症及其预防措施等。     

PITUITARY ADENOMAS PATHOLOGIC ANALYSIS OF 150 CASES WITH LIGHT AND ELECTRON MICROSCOPY

This is a pathologic analysis of 150 cases of pituitary adenomas treated surgically. According to the clinical manifestations and laboratory findings they were divided int0 5 groups: 1. those with acro megaly, 77 cases; 2. those with amenorrhea and ga- lactorrhea, 44 cases; 3. those with Cushing's syndro me, 13 cases; 4. those with hypothyroidism, 1 case; and 5. those with no specific endocrine symptoms, 15 cases. Gross and microscopic analysis of the pituitary adenomas was made together with the clinical findings. Under electron microscope, pitui- tary adenomas were classified into GH, PRL, ACTH, TSH cell adenomas, and polyfunctional adenomas.     

伴有皮质醇增多症的垂体腺瘤(13例的光镜和电镜的病理分析)

本文分析了13例临床上有皮质醇增多症的垂体腺瘤。这类腺瘤体积小,常埋在垂体前叶中。在光镜下瘤细胞较大,常成筛网状或腺状排列;胞浆嗜碱性,PAS阳性。在电镜下,瘤细胞内分泌颗粒数目较多,多为圆形,直径大部为200～300nm,电子密度不均匀,在核旁胞浆中有成束的微纤维,推测在皮质醇症中,垂体前叶中增生的嗜碱性细胞可发展成为腺瘤。     

LOCKED-IN SYNDROME (PONTOPSEUDOCOMA) REPORT OF 3 CLINICAL AND PATHOLOGIC CASE.S

Three patients are presented who at some time during their illness were alert but had complete paralysis of all voluntary movement other than of the eyeballs and eyelids by which they communicated with others Two of these patients had massive hemorrhages in the basilar part of the pons and the third might also have had pontine lesion as determined clinically. The pathologic basis of this syndrome involves the bilateral basilar part of the pons. It is emphasi- zed that the clinical manifestation of locked-in syndrome, even though it may be transient, pos- sesses diagnostically localizing significance. The term pontopseudocoma is recommended instead of locked-in syndrome.     

垂体生长激素细胞腺瘤的免疫细胞化学染色与电镜观察50例的结果比较研究

利用伴有肢端肥大症的垂体腺瘤50例手术切除的瘤组织,作电镜观察及免疫细胞化学染色。对比了滴染法与小盒长期浸泡法染色的优缺点。在电镜下看到多分泌颗粒GH细胞和少分泌颗粒GH细胞,分别与免疫细胞化学染色中的GH强阳性细胞和GH弱阳性细胞相当。在电镜下21例GH分泌颗粒与PRL颗粒并存,但在免疫细胞化学染色中,21例都为GH(+),而PRL 19例(+)、2例(一)。免疫细胞化学染色可进一步验证在电镜下看到的腺瘤中分泌颗粒的性质,提高诊断垂体腺瘤性质的准确性。