CAJ | 학술논문

目的研究垂体的被膜层次,探讨其和侵袭性垂体腺瘤之间的关系.方法取8例胎儿的鞍区标本,经冠状、矢状位连续切片,HE和Masson染色后,观察并测量各层膜性结构;另取成人标本10例,暴露鞍区各膜性结构,行解剖学观察和测量.结果垂体表面由固有膜和垂体囊共同包裹,所有标本中该两层均完整.腺垂体表面该两层膜间尚存潜在腔隙;而随着腺垂体向神经垂体过渡,两膜渐紧贴,在神经垂体表面二者紧密粘连,组织学上难以分清.垂体囊厚度不均,其上壁、上外侧和下壁厚度较薄,而下外侧壁较厚;固有膜厚度均匀.海绵窦(CS)内侧壁同其他各壁一样也是双层膜性结构,其外层由垂体囊的外侧部构成;而内层为纤维层,从其上还向CS内发出很多结缔组织纤维,覆盖窦内各神经血管外,同时将窦分隔成很多静脉腔隙.结论 CS内侧壁是由垂体囊外侧壁(硬膜结构)和纤维层共同构成的双层结构.侵袭性垂体腺瘤可能是腺瘤向鞍旁扩展造成CS内侧壁的适形性扩展而形成的影像学假象,而肿瘤和垂体囊之间尚存在外科手术界线.
목적 연구수체적피막층차,탐토기화침습성수체선류지간적관계.방법 취8례태인적안구표본,경관상、시상위련속절편,HE화Masson염색후,관찰병측량각층막성결구;령취성인표본10례,폭로안구각막성결구,행해부학관찰화측량.결과 수체표면유고유막화수체낭공동포과,소유표본중해량층균완정.선수체표면해량층막간상존잠재강극;이수착선수체향신경수체과도,량막점긴첩,재신경수체표면이자긴밀점련,조직학상난이분청.수체낭후도불균,기상벽、상외측화하벽후도교박,이하외측벽교후;고유막후도균균.해면두(CS)내측벽동기타각벽일양야시쌍층막성결구,기외층유수체낭적외측부구성;이내층위섬유층,종기상환향CS내발출흔다결체조직섬유,복개두내각신경혈관외,동시장두분격성흔다정맥강극.결론 CS내측벽시유수체낭외측벽(경막결구)화섬유층공동구성적쌍층결구.침습성수체선류가능시선류향안방확전조성CS내측벽적괄형성확전이형성적영상학가상,이종류화수체낭지간상존재외과수술계선.
Objective The purpose of this study was to examine the membranous layers of the human pituitary gland and their relationships with invasive adenomas. Method Histological and microdissection techniques were used to study 8 fetal and 10 adult human cadavers, respectively. The distribution of the membranous layers was observed, and their thickness was measured Results In all specimens, the pituitary glands were found to be coated by 2 membranous layers, the inner layer being referred to here as the lamina propria and the outer as the pituitary capsule. In all specimens, the 2 membranes were intact with no histological defects. An interstice or cavity between the 2 layers was found on the surface of the adenohypophysis. However,as these 2 layers got closer and closer to each other, they began to adhere on the surface of the neurohypophysis.The thickness of the pituitary capsule was not constant like that of the lamina propria: the inferolateral part of the capsule was thicker than the other parts. The medial wall of the cavernous sinus (CS) was also a bilayered membrane just like the other CS walls: the 2 layers of the medial CS wall were composed of the lateral part of the pituitary capsule and the fibrous layer. Many fibrous trabeculae arising from this fibrous layer divided the CS into several small venous spaces and connected the internal carotid arteries with the medial wall. Conclusions The lateral part of the capsule (dura mater) and the fibrous layer constituted the medial wall of the CS, which has a superior part that is weaker than the thicker inferior part. Invasive adenomas might be a radiological misunderstanding of the extremely displacement of the CS medial wall by the tumor's pushing. While between the tumor and the pituitary capsule, a .safety surgical interface still exists.