Abstract
PurposeTo analyze the co-expression of the intermediate filaments GFAP and cytokeratin in 326 pituitary adenomas with regard to the distribution pattern, the subtype of the adenoma and clinical prognostic data.MethodsTissue from 326 pituitary adenomas and 13 normal anterior pituitaries collected in the Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, between 2006 and 2009 was investigated by immunohistochemistry, immunofluorescence and electron microscopy.ResultsCo-expression of intermediate filaments GFAP and cytokeratin was associated with hormone expression in 62/278 cases (22%), but only found in 2/48 (4%) of null cell adenomas (p < 0.01). Simultaneous co-expression of GFAP and cytokeratin in the same cells was demonstrated in 26 out of 326 pituitary adenomas and in all 13 pituitaries. In pituitary intermediate filaments were demonstrated in a larger area of the cytoplasm than in adenoma (p < 0.01), however, overlapping expression was seen in 2.6% of the total area in both, pituitary and adenoma. Congenially, cells with overlapping expression were found near vessels and in follicles. Furthermore, adenomas with cellular co-expression of GFAP and cytokeratin were associated with a lower recurrence rate (7.7%) compared to adenomas without co-expression of intermediate filaments (17.8%).ConclusionsCellular co-expression of the intermediate filaments GFAP and cytokeratin in pituitary adenomas and the pituitary was demonstrated and shown to be associated with hormone expression and low recurrence rate. The results are discussed with regard to the biology of folliculostellate cells, neural transformation and tumor stem cells. This study may complement the understanding of pituitary adenoma biology.
Highlights
The pituitary adenoma represents the most frequent space occupying lesion in the sella turcica and accounts for 10–15% of all intracranial neoplasias
Co-expressions of different intermediate filaments in pituitary anterior lobes and in pituitary adenomas have been described in the past [2, 7]
We could prove for the first time the simultaneous cellular co-expression of the intermediate filaments GFAP and cytokeratin in pituitary adenomas (Fig. 1) as well as in pituitary anterior lobes
Summary
The pituitary adenoma represents the most frequent space occupying lesion in the sella turcica and accounts for 10–15% of all intracranial neoplasias. Velasco et al [6] and Morris and Hitchcock [7] compared the folliculostellate cells to glial cells because of their similar morphology and antigen expression pattern which includes S-100, GFAP, and vimentin [8,9,10] They are attributed control of paracrine functions in hormone synthesis and secretion as well as physiological and neoplastic cell proliferation [5, 10, 11]. Folliculostellate cells produce a variety of factors that alter the functions of neighbouring cells and express receptors for pituitary hormones This present retrospective study was undertaken to investigate the expression of intermediate filaments GFAP and cytokeratin in pituitary adenoma with relation to hormone expression and clinical parameters. Areas were manually selected using the magic wand tool and areas were related to each other (green/yellow, red/yellow; Fig. 1)
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