促性腺激素细胞增生

据说此发生在有长期原发性低性腺激素水平的病人，尤其是在年轻时缺乏性腺类固醇激素的病人，例如促性腺激素细胞增生可见于长期低性腺激素的病人（如Klinefelters综合征）的尸检中。一个奇特但还没能解决的问题是：为什么促性腺激素细胞增生在老年中不那么显著，因为这时的性腺激素的负反馈调节是缺乏的。一方面促性腺激素细胞腺瘤常见于老年人，但另一方面在长期低性腺激素病人中却又很少发生促性腺激素细胞腺瘤，这一矛盾现象表明，靶器官功能不足或有产生肿瘤的作用，但两者的关系目前还不能得到结论性的意见。

垂体增生很难诊断的原因有几个。首先，在正常垂体中，许多腺垂体细胞是不均匀分布的，如果外科标本仅有一小块，其在垂体中的准确位置无法肯定，那么垂体增生的诊断也无法肯定。另外，增生也可为局灶性并且并没包括在标本内。最后，外科切除的组织要经历人为因素如机械压迫、电凝和冰冻效应，所有这些都会干扰严格的组织评估。此外，垂体增生缺乏形态学诊断标准及外科上并不常注意到有垂体增生的存在和部分的病理学家缺乏经验，可更进一步增加诊断上的复杂性。

（卢　奕　吴智远　惠国桢）

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