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Ektopien der Hypophyse

Ectopia of the pituitary

  • Schwerpunkt: Ektopes Gewebe
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Zusammenfassung

Die Adenohypophyse hat einen weit überwiegenden intrasellären Hauptteil und weitere recht kleine Anteile am Hypophysenstiel und am Rachendach. In deren naher Umgebung, aber auch im Sinus sphenoidalis und im Sinus cavernosus können sich ektope Hypophysenadenome ausbilden, die sich strukturell und funktionell nicht von den üblichen intrasellären Adenomen unterscheiden lassen. Die Neurohypophyse kann Dystopien besonders im Rahmen von komplexen Missbildungen zeigen, aber auch beim sog. Pituitary-Stalk-Interruption-Syndrom echte Ektopien an der Eminentia mediana aufweisen. Ektopes Gewebe in der Hypophyse ist extrem selten: Es wurden Ganglienzellnester in der Neurohypophyse und Nebennierenrindengewebe in der Adenohypophyse nachgewiesen. Umschriebene Plattenepithelherde in der Adenohypophyse sind häufig und stellen Metaplasien von Parenchymzellen oder Reste des Ductus craniopharyngeus dar. Ektopien von Speicheldrüsengewebe sind in sehr kleinen Herden in der Intermediärzone nicht selten.

Abstract

The adenohypophysis has a large intrasellar part and two small parts at the pituitary stalk and the pharynx. Near this extrasellar pituitary tissue, and also in sinus sphenoidalis and sinus cavernosus, ectopic pituitary adenomas can develop. They are indistinguishable in structure and function from usual intrasellar adenomas. The neurohypophysis can show dystopias within complex malformations. In so-called pituitary stalk interruption syndrome, a real ectopia of the neurohypophysis is found at the eminentia mediana of the hypothalamus. Ectopic tissue in the pituitary is extremely rare: foci of ganglionic cells were found in the neurohypophysis and adrenocortical tissue in the adenohypophysis. Focal squamous epithelia in the anterior pituitary are a common finding but they are rather metaplastic from parenchymal cells than ectopic tissue. Small foci of ectopic salivary gland tissue are not rare in the intermediate zone.

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Danksagung

Mein Dank gilt der Novartis Pharma GmbH (Nürnberg), der Novo Nordisk Pharma GmbH (Mainz), der Pfizer Pharma GmbH (Karlsruhe) und der Ipsen Pharma GmbH (Ettlingen) als den Sponsoren des Hypophysentumorregisters der Deutschen Gesellschaft für Endokrinologie, ohne die viele Untersuchungen dieses Registers nicht möglich gewesen wären. Der Autor dankt allen Pathologen, die seinen Konsiliardienst nutzen. Daraus ergaben sich anregende Gespräche, neue Ideen und interessante Kasuistiken.

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  1. Institut für Neuropathologie, UKE, Universität Hamburg, Martinistraße 52, 20246, Hamburg, Deutschland

    W. Saeger

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W. Saeger gibt an, dass das Hypophysentumorregister der Deutschen Gesellschaft für Endokrinologie durch die Novartis Pharma GmbH (Nürnberg), Novo Nordisk Pharma GmbH (Mainz), Pfizer Pharma GmbH (Berlin) und Ipsen Pharma GmbH (Berlin) gefördert wird.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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W. Saeger, Hamburg,

K. W. Schmid, Essen

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Saeger, W. Ektopien der Hypophyse. Pathologe 39, 373–378 (2018). https://doi.org/10.1007/s00292-018-0473-3

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