1994 Volume 33 Issue 6 Pages 1092-1097
A case of pituitary adenocarcinoma in which tumor cells were detected in the cerebrospinal fluid (CSF) is described. A 48-year-old woman was diagnosed by CT as having a tumor spreading over not only the suprasellar superior cisterna but the left frontal lobe as well.The tumor was eventually determined to have metastasized into the left occipital lobe, brain stem, cerebrellopontile angles bilaterally, and spinal cord.
Cell features: Tumor cells in the CSF varied greatly in size and were roundish in shape.They were sporadic or formed sheets, although a few large multinucleate giant cells with many vacuoles in their extensive cytoplasm were also observed sporadically.
Immunocytochemical findings: The GH, ACTH and prolactin (PRL) reactions were performed using tumor cells in the CSF.Dark-brown granules predominantly positive for GH were observed in the tumor cell cytoplasm, whereas testing was negative for ACTH and PRL.
Immunoelectron-microscopic findings: The GH reaction was performed on tumor cells in the CSF by the protein-A gold method. A large number of mitochondria and secretory granules with high electron density measuring about 200nmin diameter were observed in the cytoplasm of the tumor cells.The fact that GH-positive gold granules were always observed in association with round secretory granules proved that the tumor cells produced GH themselves, and had not trapped GH from their surroundings.
