Secondary vs. primary pituitary xanthogranulomas: which yellow is more mellow?

IF 1.3 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Endocrine journal Pub Date : 2024-03-28 Epub Date: 2024-01-27 DOI:10.1507/endocrj.EJ23-0398
Dragana Miljic, Sandra Pekic, Mirjana Doknic, Marko Stojanovic, Sasa Ilic, Marina Nikolic Djurovic, Zvezdana Jemuovic, Toplica Milojevic, Mihailo Milicevic, Marija Jovanovic, Milica Medic Stojanoska, Bojana Carić, Nevena Radic, Sanja Medenica, Emilija Manojlovic Gacic, Milan Petakov
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Abstract

Pituitary xanthogranulomatomas (XG) are a rare pathological entity caused by accumulation of lipid laden macrophages and reactive granuloma formation usually triggered by cystic fluid leakage or hemorrhage. Our aim was to compare clinical characteristics and presenting features of patients with secondary etiology of XG and those with no identifiable founding lesion (primary -"pure" XG) in order to gain new insights into this rare pituitary pathology. In a retrospective review of 714 patients operated for sellar masses, at tertiary center, we identified 16 (2.24%) with histologically confirmed diagnosis of pituitary XG over the period of 7 years (2015-2021). Patients were further analyzed according to XG etiology: "pure"- XG (n = 8) with no identifiable founding lesion were compared to those with histological elements of pituitary tumor or cyst - secondary XG (n = 8). We identified 16 patients (11 male), mean age 44.8 ± 22.3 years, diagnosed with pituitary XG. Secondary forms were associated with Ratke's cleft cyst (RCC, n = 2) and pituitary adenoma (PA, n = 6). The most common presenting features in both groups were hypopituitarism (75%), headache (68.5%) and visual disturbances (37.5%). Predominance of male sex was noted (males 68.75%, females 31.25%), especially in patients with primary forms. Patients with primary pituitary XG were all males (p = 0.0256) and more frequently affected by panhypopituitarism (87.5% vs. 25%, p = 0.0406) compared to patients with secondary causes. Hyperprolactinemia was noted in pituitary tumor group with secondary etiology only (p = 0.0769). Majority of lesions were solid on magnetic resonance imaging - MRI (81.25%). Distinct clinical phenotype was observed dependent on the etiology of XG.

继发性与原发性垂体黄疽:哪种黄色更柔和?
垂体黄质粒肉瘤(XG)是一种罕见的病理实体,是由载脂巨噬细胞聚集和反应性肉芽肿形成引起的,通常由囊液渗漏或出血引发。我们的目的是比较继发性 XG 和无可识别原发病灶(原发性-"纯 "XG)患者的临床特点和表现特征,以便对这种罕见的垂体病变有新的认识。在对三级医疗中心的 714 名因蝶窦肿块接受手术的患者进行的回顾性研究中,我们发现 16 名患者(2.24%)在 7 年内(2015-2021 年)经组织学确诊为垂体 XG。根据XG病因对患者进行了进一步分析:将无可辨认创始病灶的 "纯 "XG(8例)与组织学要素为垂体瘤或囊肿的继发性XG(8例)进行比较。我们共发现了 16 例确诊为垂体 XG 的患者(男性 11 例),平均年龄(44.8 ± 22.3)岁。继发性XG与拉特克氏裂囊肿(RCC,n = 2)和垂体腺瘤(PA,n = 6)有关。两组患者最常见的症状是垂体功能减退(75%)、头痛(68.5%)和视力障碍(37.5%)。男性占多数(男性占 68.75%,女性占 31.25%),尤其是原发性患者。原发性垂体 XG 患者均为男性(p = 0.0256),与继发性患者相比,更常出现泛垂体功能障碍(87.5% 对 25%,p = 0.0406)。仅继发性垂体瘤组患者出现高催乳素血症(p = 0.0769)。磁共振成像(MRI)显示,大多数病灶为实性(81.25%)。根据 XG 的病因,可观察到不同的临床表型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Endocrine journal
Endocrine journal 医学-内分泌学与代谢
CiteScore
4.30
自引率
5.00%
发文量
224
审稿时长
1.5 months
期刊介绍: Endocrine Journal is an open access, peer-reviewed online journal with a long history. This journal publishes peer-reviewed research articles in multifaceted fields of basic, translational and clinical endocrinology. Endocrine Journal provides a chance to exchange your ideas, concepts and scientific observations in any area of recent endocrinology. Manuscripts may be submitted as Original Articles, Notes, Rapid Communications or Review Articles. We have a rapid reviewing and editorial decision system and pay a special attention to our quick, truly scientific and frequently-citable publication. Please go through the link for author guideline.
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