Pituitary adenoma with rich folliculo-stellate cells and mucin-producing epithelia arising in a 2-year-old girl.
Pituitary adenoma is a rare neoplasm in childhood, with prolactin and adrenocorticotropic hormone (ACTH)-secreting adenomas predominating in this age group. Herein is reported a case of an ACTH-producing macroadenoma with an unusual histology that occurred in a 2-year-old girl. Because of the patient's age and the macroadenoma's suprasellar location and large size (up to 4 cm in diameter), radical surgery was performed under the suspicion of craniopharyngioma or germ-cell tumor. Pathologically, it was a unique pituitary adenoma composed of monotonous ACTH-producing cells, smaller folliculo-stellate cells (FSC), and mucin-producing cells. The FSC, non-hormone-secreting pituitary cells of uncertain function, were confirmed by their S-100 protein, glial fibrillary acidic protein and cytokeratin expression immunoprofiles. The abrupt transition between the prominent gland-forming mucin-producing epithelia and the FSC component suggested that the mucin-producing epithelia might be derived from the FSC. This association might represent so-called 'retrodifferentiation' of adenoma cells to the FSC and the precursor cells of Rathke's pouch.
Department of Pathology, Seoul National University College of Medicine, Chongno-gu, Seoul, Korea.
Hye Sook
HS
Min
Seung June
SJ
Lee
Seung-Ki
SK
Kim
Sung-Hye
SH
Park
D049913:ACTH-Secreting Pituitary Adenoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000378:metabolism; D002675:Child, Preschool; D003593:Cytoplasm / Q000648:ultrastructure; D018450:Disease Progression; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006801:Humans; D007633:Keratins / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009077:Mucins / Q000378:metabolism*; D010911:Pituitary Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D009418:S100 Proteins / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D005904:Glial Fibrillary Acidic Protein; D009077:Mucins; D009418:S100 Proteins; D007633:Keratins