title: Cytomorphology of metastatic pituitary carcinoma to the bone.
abstract: Metastatic pituitary carcinoma to bone is rare. In this report, we present a case of a 59-year-old female with recurrent pituitary adenoma of the sparsely granulated somatotroph subtype with metastasis to a few bony sites 10 years later. Needle core biopsy (NCB) with touch preparations was performed on a 5 mm lesion in left ilium. Diff-Quik stained NCB touch preparation slides showed a few loosely cohesive epithelial polygonal cells that were arranged in nests or acini, or singly, had scant vacuolated cytoplasm and eccentrically located round nuclei (plasmacytoid) with slight nuclear pleomorphism, fine granular chromatin, conspicuous nucleoli, and smooth nuclear membrane. Trilineage hematopoietic cells of bone marrow were also appreciated in the background. H&E stained core sections showed fragments of bone and bone marrow with nests of bland epithelial cells with similar cytomorphology as seen in NCB touch preparation slides. The tumor cells were immunoreactive for juxtanuclear dot-like staining of pan-cytokeratin (CAM 5.2 and AE1/AE3) (a specific feature), neuroendocrine markers (CD56, synaptophysin, and chromogranin. Additionally, scattered cells were immunoreactive for growth hormone. Molecular test showed that tumor cells were negative for the promoter methylation of O-6-Methylguanine-DNA Methyltransferase (MGMT). Final diagnosis of metastatic pituitary carcinoma was rendered. Morphology of metastatic pituitary carcinoma, its differential, clinical presentation and treatment were discussed. Diagn. Cytopathol. 2017;45:645-650. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Chandler
authors.affiliation: Department of Pathology, Northwestern University, Chicago, Illinois.
authors.forename: Xiaoqi
authors.identifier: http://orcid.org/0000-0002-0760-3950
authors.initials: X
authors.lastname: Lin
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000556:secondary; D001457:Anion Exchange Protein 1, Erythrocyte / Q000235:genetics; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000235:genetics*; D062005:Biopsy, Large-Core Needle; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000556:secondary; D019002:CD56 Antigen / Q000235:genetics; D053379:Chromogranin A / Q000235:genetics; D005260:Female; D015870:Gene Expression; D013006:Growth Hormone / Q000235:genetics; D006801:Humans; D007085:Ilium / Q000378:metabolism / Q000473:pathology; D007633:Keratins / Q000235:genetics; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016708:Synaptophysin / Q000235:genetics
chemical_list: D001457:Anion Exchange Protein 1, Erythrocyte; D015415:Biomarkers; D014408:Biomarkers, Tumor; C400901:CAM 5.2 antigen; D019002:CD56 Antigen; C506150:CHGA protein, human; D053379:Chromogranin A; C522918:NCAM1 protein, human; C569014:SYP protein, human; D016708:Synaptophysin; D007633:Keratins; D013006:Growth Hormone
keywords: cytomorphology; immunohistochemistry; metastasis; needle core biopsy; pituitary carcinoma