Spindle cell oncocytoma of adenohypophysis: Cytogenetics and β-catenin findings with pathology differential diagnosis and review of the literature

Jianwu Xie, Jan F. Silverman, Cunfeng Pu, Scott Graner, Patrick Storto, Ines Donangelo, Katherine M. Jasnosz

Research output: Contribution to journalArticle

Abstract

Spindle cell oncocytoma (SCO) is an extremely rare neoplasm arising in the anterior pituitary. We report comprehensive pathological description of a case of SCO in a 60 year-old male who presented with nausea, vomiting and severe hyponatremia, and pan hypopituitarism. Magnetic resonance imaging (MRI) showed a 3.1 × 2.3 × 2.0 cm homogeneously enhancing bilobed mass within the sella turcica and suprasellar cistern. Intraoperative frozen section and touch imprint cytology showed cohesive spindle cells with abundant oncocytic cytoplasm. Histologic sections revealed the tumor was composed of interlacing fascicles of compact spindled cells with abundant dense oncocytic cytoplasm. There was no mitosis or necrosis present. Ki-67 index varied in areas, with an average of 3%. By immunohistochemistry (IHC), the tumor cells were negative for Cam5.2, AE1/3, neurofilament (NF), NeuN, glial fibrillary acidic protein (GFAP) and synaptophysin, and strongly positive for vimentin, TTF-1 and EMA. S-100 showed focal weakly positivity. By electron microscopy (EM), the cytoplasm of the spindle cells contained numerous abundant, back-to-back, uniform, round, normal-sized mitochondria with long and lamellar cristae. Beta-catenin showed diffuse membranous and partial cytoplasmic positivity. Cytogenetic analysis showed extra copies of chromosome 1 (74%, up to 8 copies), and loss of chromosome 2 (35%). The histogenesis, classification and differential diagnosis are discussed.

Original languageEnglish (US)
Pages (from-to)71-75
Number of pages5
JournalHuman Pathology: Case Reports
Volume9
DOIs
StatePublished - Sep 1 2017

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Oxyphilic Adenoma
Catenins
Anterior Pituitary Gland
Cytogenetics
Differential Diagnosis
Pathology
Cytoplasm
Sella Turcica
Neoplasms
Hypopituitarism
Synaptophysin
Chromosomes, Human, Pair 2
Intermediate Filaments
Hyponatremia
Chromosomes, Human, Pair 1
Cytogenetic Analysis
Glial Fibrillary Acidic Protein
Touch
beta Catenin
Frozen Sections

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Xie, Jianwu ; Silverman, Jan F. ; Pu, Cunfeng ; Graner, Scott ; Storto, Patrick ; Donangelo, Ines ; Jasnosz, Katherine M. / Spindle cell oncocytoma of adenohypophysis : Cytogenetics and β-catenin findings with pathology differential diagnosis and review of the literature. In: Human Pathology: Case Reports. 2017 ; Vol. 9. pp. 71-75.
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abstract = "Spindle cell oncocytoma (SCO) is an extremely rare neoplasm arising in the anterior pituitary. We report comprehensive pathological description of a case of SCO in a 60 year-old male who presented with nausea, vomiting and severe hyponatremia, and pan hypopituitarism. Magnetic resonance imaging (MRI) showed a 3.1 × 2.3 × 2.0 cm homogeneously enhancing bilobed mass within the sella turcica and suprasellar cistern. Intraoperative frozen section and touch imprint cytology showed cohesive spindle cells with abundant oncocytic cytoplasm. Histologic sections revealed the tumor was composed of interlacing fascicles of compact spindled cells with abundant dense oncocytic cytoplasm. There was no mitosis or necrosis present. Ki-67 index varied in areas, with an average of 3{\%}. By immunohistochemistry (IHC), the tumor cells were negative for Cam5.2, AE1/3, neurofilament (NF), NeuN, glial fibrillary acidic protein (GFAP) and synaptophysin, and strongly positive for vimentin, TTF-1 and EMA. S-100 showed focal weakly positivity. By electron microscopy (EM), the cytoplasm of the spindle cells contained numerous abundant, back-to-back, uniform, round, normal-sized mitochondria with long and lamellar cristae. Beta-catenin showed diffuse membranous and partial cytoplasmic positivity. Cytogenetic analysis showed extra copies of chromosome 1 (74{\%}, up to 8 copies), and loss of chromosome 2 (35{\%}). The histogenesis, classification and differential diagnosis are discussed.",
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Spindle cell oncocytoma of adenohypophysis : Cytogenetics and β-catenin findings with pathology differential diagnosis and review of the literature. / Xie, Jianwu; Silverman, Jan F.; Pu, Cunfeng; Graner, Scott; Storto, Patrick; Donangelo, Ines; Jasnosz, Katherine M.

In: Human Pathology: Case Reports, Vol. 9, 01.09.2017, p. 71-75.

Research output: Contribution to journalArticle

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