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Prolactin-cell adenoma with signet-ring cells: a case report.
MedLine Citation:
PMID:  21726505     Owner:  NLM     Status:  In-Data-Review    
Objective: Signet-ring cell changes in the pituitary adenomas are extremely rare. To date, there have been only two reports documenting signet-ring cells in pituitary adenomas, one in a growth-hormone cell adenoma and the other in a nullcell adenoma. This report describes, for the first time, signet-ring cells in a prolactincell adenoma. Case history: The patient is a 46-year-old male who presented with severe headache and acute on chronic visual loss. Radiographic studies demonstrated a large cystic pituitary lesion with evidence of pituitary apoplexy. Laboratory values were consistent with a prolactin-cell adenoma. The patient underwent transsphenoidal resection of the prolactin-cell adenoma with significant post-operative improvement. Results: The tumor was composed of sheets of monomorphic round cells with conspicuous nuclei and granular cytoplasm, consistent with pituitary adenoma. Many cells had eccentric, often crescentic-shaped nuclei, imparting a signet-ring appearance and immunostaining was positive for prolactin, denoting an atypical prolactin-cell adenoma. The MIB-1 labeling index was slightly elevated. Electron microscopy demonstrated the presence of vacuolated areas in the cytoplasm that were not membrane bound and did not have specific inclusions. Discussion: This case augments the literature on pituitary adenomas with signet-ring cells. The clinical significance of signet-ring cells in pituitary adenomas is unknown. Accumulation of clinical cases, together with the advances in molecular techniques and experimental models, may yield further insight.
E Binello; C Cunliffe; K D Post; G M Kleinman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical neuropathology     Volume:  30     ISSN:  0722-5091     ISO Abbreviation:  Clin. Neuropathol.     Publication Date:    2011 Jul-Aug
Date Detail:
Created Date:  2011-07-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214420     Medline TA:  Clin Neuropathol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  192-6     Citation Subset:  IM    
Department of Neurosurgery, and Division of Neuropathology, Department of Pathology, Mount Sinai Medical Center, New York, NY, USA.
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