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Prolactin-producing pituitary adenoma with incomplete neuronal transformation: an intermediate adenoma–neuronal tumor

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Abstract

We present a unique case of a prolactin (PRL)-producing pituitary adenoma showing incomplete neuronal differentiation without ganglion cells. A 27-year-old man presented with nausea, headaches, and instability over the last 2 months. Clinical examination revealed obesity with no other endocrinological signs. His serum PRL levels were slightly elevated (38 ng/ml), whereas concentrations of the other adenohypophysial hormones were within normal range. Histology revealed an unusual pituitary adenoma containing many hypocellular areas with fibrillar appearance. The sizable tumor cells were polyhedral or elongated harboring an ovoid, vesicular nucleus with prominent nucleolus, lacking, however, the typical features of ganglion cells. By immunohistochemistry, many adenoma cells were positive for PRL. Immunostain for neurofilament protein revealed variable amounts of fibrils dispersed throughout the stroma, mostly in the hypocellular areas. In addition, neurofilament protein and chromogranin were strongly reactive in approximately 15% of the tumor cell population, whereas reactivity for synaptophysin was uniform throughout the tumor. These findings led to the conclusion that part of the tumor-cell population expressed a hybrid immunoprofile of adenoma–neuronal cell. Our case is the first PRL-producing pituitary adenoma showing incomplete neuronal differentiation lacking mature ganglion cells.

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Acknowledgements

The authors are indebted to the National Hormone and Pituitary Program (NHPP), Torrance, California, USA, for providing the pituitary hormone antibodies.

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Authors and Affiliations

  1. Departments of Pathology, 1G. Gennimatas General Hospital of Athens, KOFKA Building, 1st Floor, 154 Messogion Ave., , 115 27, Athens, Greece

    Eleni Thodou & George Kontogeorgos

  2. 2 St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

    George Kontogeorgos, Eva Horvath & Kalman Kovacs

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  1. Eleni Thodou
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  2. George Kontogeorgos
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  3. Eva Horvath
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  4. Kalman Kovacs
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Correspondence to George Kontogeorgos.

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Thodou, E., Kontogeorgos, G., Horvath, E. et al. Prolactin-producing pituitary adenoma with incomplete neuronal transformation: an intermediate adenoma–neuronal tumor. Acta Neuropathol 108, 115–120 (2004). https://doi.org/10.1007/s00401-004-0862-y

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