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Brain and Nerve No to Shinkei Volume 33, Issue 6 （June 1981）

Brain and Nerve 脳と神経 33巻6号（1981年6月発行）

Japanese English

原著

Subclinical pituitary microadenoma SUBCLINICAL PITUITARY MICROADENOMA 寺本明 ¹ , 田村晃 ¹ , 堀智勝 ¹ , 佐野圭司 ¹ , 平川公義 ² , 長村義之 ³ , 渡辺慶一 ³ Akira Teramoto ¹ , Akira Tamura ¹ , Tomokatsu Hori ¹ , Keiji Sano ¹ , Kimiyoshi Hirakawa ² , Yoshiyuki Osamura ³ , Keiichi Watanabe ³ ¹東京大学脳神経外科 ²京都府立医科大学脳神経外科 ³東海大学病理 ¹Department of Neurosurgery, University of Tokyo Hospital. ²Department of Neurosurgery, Kyoto Prefectural University of Medicine. ³Department of Pathology, Tokai University. pp.625-632

発行日 1981年6月1日 Published Date 1981/6/1

DOI https://doi.org/10.11477/mf.1406204781

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Abstract 文献概要
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1．緒言

　近年，下垂体前葉ホルモンのRadioirnmunoassayの確立に伴い，functioning pituitary microadenoma （ホルモン産生下垂体微小腺腫）という新しい臨床概念が生まれ，目下，症例数は増加の一途をたどりつつある。

　これらは，従来の臨床的な下垂体腺腫の初期段階であろうと推定されているが，必ずしもすべてのmicroade—nomaが，macroadenoma （microadenomaに対して仮にこう呼ぶ）に成長することには疑問があるとされる^8）。

In order to investigate the incidence and his-tological features of subclinical pituitary micro-adenomas, one thousand pituitary glands obtained from necropsies were studied (Fig. 1). Most of death resulted from acute diseases or accidents; i. e. cardi-ac failure (388), accidents (220), cerebrovascular disease (138), pneumonia (93), gastroenteric disease (71) and other causes (90).

The pituitaries were fixed in 10% buffered forma-lin and then cut in the horizontal or frontal planes, producing three pieces. They were embedded in the paraffin, sectioned and stained with Hematoxi-lin and Eosin in the usual way.

Fifty-eight pituitary glands (5.8%) were found to contain discrete microadenomas varying in size from 0.5 to 5.5mm in diameter. The frequency of them was significantly high in the fifth and eighth decades, while the incidence in both sexes was almost equal (Fig. 2 and Table 1). The sizes of subclinical microadenomas tended to increase with advancing age, except for some large ones found in the fifth decade (Fig. 3). Forty-four cases of them (76%) were localized in the lateral wing and the others were found near or in the mucoid wedge (Fig. 4 & 5).

With H-E stain, they were classified into 55 chromophobe and three eosinophilic adenomas.

In an attempt to identify the endocrinological functions of these adenomas, 30 cases were studied by peroxidase-labeled antibody methods using anti-bodies against human PRL, GH, ACTH, TSH, FSH and LH (Fig. 6 & 7).

With immunostains, they were devided into 9 PRL producing, two GH producing and 19 non-functioning adenomas. PRL adenomas were pre-dominantly localized in the anterolateral portion of the pituitary gland, while GH adenomas were seen more medially (Fig. 5).

Since immunohistochemical findings of these functioning adenomas were in accordance with those of clinical adenomas, it was supposed that some subclinical microadenomas could develop into clinical tumors.