Pituitary adenoma combined with astrocytoma/ganglioglioma: a clinicopathologic study of eight cases and review of literature

Objective To investigate the pathogenes,clinicopathologic characteristics,diagnosis and differential diagnosis of the pituitary adenoma combined with astrocytoma/ganglioglioma.Methods Eight cases of pituitary adenoma combined with astrocytoma/ganglioglioma were stuided by clinical data analysis,histopathology and immunohistochemistry(SP or EnVision method).Results All the patients were female,with age ranged from 10 to 35 years(average 25.25 years).Clinically,seven patients presented with endocrinological symptoms.Microscopically,the tumor consisted of two structures: some tumors were spindle cells with round-oval to elongated-irregular nuclei which arranged in storiform pattern and interlacing fascicles;others were similar cells in size and shapes,with round-oval nuclei,abundant and acidophilic or pale cytoplasma.Immunohistochemically,spindle cells were positive for GFAP,ganglionic cells were positive for Syn,while the round cells were immunoreactive for PrL or GH.Conclusions Pituitary adenoma combined with astrocytoma/ganglioglioma is a very rare mixed pituitary tumor with good prognosis.The pathogenesis may be that the first tumor arising from neuroepithelial/glial cells of lobe posterior or endrocrine cells of anterior lobe pituitary stimulates the above cells proliferation,and results in the second tumor subsequently.The diagnosis of pituitary adenoma combined with astrocytoma/ganglioglioma depends mainly on histopathology as well as immunohistochemical staining.