title: Combined gangliocytoma and prolactinoma of the pituitary gland.
abstract: Gangliocytomas of the pituitary gland are rare lesions that often occur in combination with pituitary adenomas, which are frequently associated with the hypersecretion of pituitary hormones, particularly growth hormones. We report a case of combined gangliocytoma and prolactinoma of the pituitary gland. A 49-year-old male presented with vertigo. Radiological examination revealed an intrasellar tumor with a suprasellar extension, which was removed via the trans-sphenoidal approach. Histologically, the tumor was composed of adenoma cells, mature ganglion cells and cells with features intermediate between those of adenoma cells and ganglion cells (intermediate cells). Immunohistochemical analysis revealed the ganglion cells and intermediate cells as well as adenoma cells to be positive for prolactin. No growth hormone-positive tumor cells were observed. The ganglion cells were positive for synaptophysin and neurofilament. The findings in this case are discussed in relation to hypotheses proposed for histogenesis, and the presence of intermediate cells supports three hypotheses. The first is that adenoma cells transform into ganglion cells, and the second is that both components originate from the embryonal pituitary cell rests, showing intermediate features between ganglion cells and adenoma cells. The last is that their common origin may be the same stem/progenitor cells in normal adult pituitaries.
authors.affiliation: Division of Diagnostic Pathology, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan. mikami-s@sc.itc.keio.ac.jp
authors.forename: Shuji
authors.initials: S
authors.lastname: Mikami
authors.forename: Kaori
authors.initials: K
authors.lastname: Kameyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Yoshida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kawase
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Sano
authors.forename: Makio
authors.initials: M
authors.lastname: Mukai
mesh_terms: D004396:Coloring Agents; D004801:Eosine Yellowish-(YS); D005456:Fluorescent Dyes; D005729:Ganglioneuroma / Q000150:complications / Q000473:pathology*; D006261:Headache / Q000209:etiology; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016612:Paraffin Embedding; D010907:Pituitary Hormones / Q000097:blood; D010911:Pituitary Neoplasms / Q000150:complications / Q000473:pathology*; D015175:Prolactinoma / Q000150:complications / Q000473:pathology*; D016707:Tissue Fixation; D014717:Vertigo / Q000209:etiology
chemical_list: D004396:Coloring Agents; D005456:Fluorescent Dyes; D010907:Pituitary Hormones; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin