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著作: Wang Elaine Lu/[銭 志栄]/Yamada Shozo/Rahman Md Mustafizur/Inosita Naoko/[影治 照喜]/Endo Hideko/Kudo Eiji/Sano Toshiaki/Clinicopathological characterization of TSH-producing adenomas: special reference to TSH-immunoreactive but clinically non-functioning adenomas./[Endocrine Pathology]

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212955
EOID
850920
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2017年3月21日(火) 16:05:20
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三木 ちひろ
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[部長]/[徳島大学.病院.中央診療施設等.地域脳神経外科診療部]
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種別 必須 学術論文(審査論文)
言語 必須 英語
招待 推奨
審査 推奨 Peer Review
カテゴリ 推奨 研究
共著種別 推奨
学究種別 推奨 博士後期課程学生による研究報告
組織 推奨
著者 必須
  1. (英) Wang Elaine Lu
    役割 任意
    貢献度 任意
    学籍番号 推奨
  2. 銭 志栄
    役割 任意
    貢献度 任意
    学籍番号 推奨
  3. (英) Yamada Shozo
    役割 任意
    貢献度 任意
    学籍番号 推奨
  4. (英) Rahman Md Mustafizur
    役割 任意
    貢献度 任意
    学籍番号 推奨
  5. (英) Inosita Naoko
    役割 任意
    貢献度 任意
    学籍番号 推奨
  6. 影治 照喜
    役割 任意
    貢献度 任意
    学籍番号 推奨
  7. (英) Endo Hideko
    役割 任意
    貢献度 任意
    学籍番号 推奨
  8. (英) Kudo Eiji
    役割 任意
    貢献度 任意
    学籍番号 推奨
  9. (英) Sano Toshiaki
    役割 任意
    貢献度 任意
    学籍番号 推奨
題名 必須

(英) Clinicopathological characterization of TSH-producing adenomas: special reference to TSH-immunoreactive but clinically non-functioning adenomas.

副題 任意
要約 任意

(英) Thyrotropin (thyroid-stimulating hormone (TSH))-producing pituitary adenomas have been known to be quite variable in clinical features covering from typical functioning TSH-producing adenomas (FTSHomas) associated with hyperthyroidism to clinically silent TSH cell adenomas (STAs) that are apparently unassociated with hyperthyroidism. It is important to distinguish STAs from other types of clinically non-functioning adenomas for adequate postoperative managements. However, because of rareness of TSH-producing adenomas, their histopathological features linking to the clinical manifestations have not been well characterized. Herein, we investigated clinical and histopathological findings to characterize 29 TSH-producing adenomas including 20 FTSHomas and nine STAs. Clinical symptoms of the patients with STAs included headache, visual defect, vertigo, and nausea. All STAs and 19 FTSHomas were macroadenoma. The average tumor size of STAs was significantly larger than that of FTSHomas (P < 0.05). The invasiveness was detected in 33% STAs and in 20% FTSHomas. Both STAs and FTSHomas showed a variety of morphological features and immunohistochemical profiles. Chromophobic polygonal or short-spindled tumor cells usually proliferated in a diffuse pattern, while they exhibited globoid or whorl-like appearance with intertwined cytoplasmic processes in both subgroups. Stromal fibrosis and calcification were often noted. Their nuclei were somehow pleomorphic. Ultrastructural features of all four STAs examined were similar to those of normal thyrotrophs. Thus, STAs and FTSHomas were indistinguishable by histology alone. Immunohistochemically, the number of TSH-positive cells in individual FTSHomas was highly various. Six tumors showed only a few TSH-positive cells (1-5%), and three were negative for TSH by conventional method without antigen retrieval. After proteinase K treatment, these tumors turned out TSH positive. As defined, STAs were TSH positive in more than 20% of tumor cells and three of them in more than 50%. Growth hormone- and/or prolactin-positive cells were detected in 55% STAs and 63% FTSHomas. Both pituitary-specific transcription factor 1 and GATA-binding protein 2 were expressed in all STAs and 20 FTSHomas. Membranous somatostatin receptor (SSTR)-2A immunoreactivity was found in 89% STAs and 94% FTSHomas, whereas SSTR5 was positive in 78% of both STAs and FTSHomas. MIB-1 labeling index was related to tumor invasiveness and tumor size (P < 0.05, P = 0.09, respectively). Thus, although both STAs and FTSHomas showed unique histopathological features distinct from other type adenomas, these two subgroups were indistinguishable by histopathology. Immunohistochemistry for TSH by use of antigen retrieval, transcription factors, and SSTRs may be useful to confirm STAs and to determine the postoperative therapy among various kinds of clinically non-functioning adenomas.

キーワード 推奨
  1. (英) Adenoma
  2. (英) Adult
  3. (英) Aged
  4. (英) Diagnosis, Differential
  5. (英) Female
  6. (英) GATA2 Transcription Factor
  7. (英) Headache
  8. (英) Humans
  9. 免疫組織化学(immunohistochemistry)
  10. (英) Male
  11. (英) Microscopy, Electron, Scanning
  12. (英) Middle Aged
  13. (英) Nausea
  14. (英) Neoplasm Invasiveness
  15. (英) Neoplasm Recurrence, Local
  16. (英) Pituitary Neoplasms
  17. (英) RNA, Messenger
  18. (英) Receptors, Somatostatin
  19. (英) Reverse Transcriptase Polymerase Chain Reaction
  20. (英) Thyrotropin
  21. (英) Transcription Factor Pit-1
  22. (英) Vertigo
  23. (英) Vision Disorders
発行所 推奨
誌名 必須 Endocrine Pathology(Endocrine Pathology Society)
(pISSN: 1046-3976, eISSN: 1559-0097)
ISSN 任意 1559-0097
ISSN: 1046-3976 (pISSN: 1046-3976, eISSN: 1559-0097)
Title: Endocrine pathology
Title(ISO): Endocr Pathol
Supplier: Springer Online Journal Archive
Publisher: Springer
 (NLM Catalog  (Scopus  (CrossRef (Scopus information is found. [need login])
必須 20
必須 4
必須 209 220
都市 任意
年月日 必須 2009年 12月 1日
URL 任意
DOI 任意 10.1007/s12022-009-9094-y    (→Scopusで検索)
PMID 任意 19774499    (→Scopusで検索)
NAID 任意
WOS 任意 000271529900003
Scopus 任意 2-s2.0-70449526195
評価値 任意
被引用数 任意
指導教員 推奨
備考 任意
  1. (英) Affiliation: Department of Human Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, Tokushima 770-8503, Japan.

  2. (英) PublicationType: Journal Article