PMC8601832_01
MRI lumbar spine with contrast showing grade 1 spondylolisthesis at L5-S1 with S1-S2 disk space causing severe spinal stenosis. There is a large object extending inferiorly from L5-S1 disk space.
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She was sent for neuroimaging of the lumbar spine (Figures 1 and 2).
MRI lumbar spine with contrast showing an intradural and enhancing mass in the L5-S1 disc space causing severe stenosis within the intradural space. This object is an intradural enhancing mass causing severe stenosis within the intradural space.
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She was sent for neuroimaging of the lumbar spine (Figures 1 and 2). In August 2020, she was admitted to the hospital for surgical resection of an intradural tumor causing severe debilitating spinal stenosis (Figure 2).
Intraoperative frozen section evaluation showing a homogeneous population of tumor cells with round nuclei, indistinct nucleoli, and cytoplasmic granules (200x magnification).
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Intraoperative frozen section pathology showed histologic features compatible with pituitary neoplasm (Figure 3).
Permanent pathology demonstrating minimal nuclear pleomorphism and only rare mitotic figures (400x magnification).
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Permanent pathology showed minimal nuclear pleomorphism of tumor cells and overall histomorphology similar to a typical pituitary adenoma (Figure 4).
Immunohistochemical stain for prolactin showing prominent granular cytoplasmic staining with perinuclear Golgi pattern accentuation (400x magnification).
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Immunohistochemistry confirmed the presence of prolactin in tumor cells (Figure 5) and showed a moderately increased Ki-67 (Figure 6) proliferation index (18%; pituitary adenoma usually <3%).
Immunohistochemical stain for Ki-67 showing a proliferation index of 18% by 1000 tumor cell count (400x magnification).
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Immunohistochemistry confirmed the presence of prolactin in tumor cells (Figure 5) and showed a moderately increased Ki-67 (Figure 6) proliferation index (18%; pituitary adenoma usually <3%).