Pituitary adenoma classification: Difference between revisions

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===Classification based on the size of the adenoma===
===Classification based on the size of the adenoma===
The radioanatomical classification places adenomas into 1 of 4 grades:<ref name=National Cancer institute> Pituitary adenoma (2015). http://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq#section/_96. Accessed on 9 28 2015.</ref>
The radioanatomical classification places adenomas into 1 of 4 grades:<ref name=National Cancer institute> Pituitary adenoma (2015). http://www.cancer.gov/types/pituitary/hp/pituitary-treatment-pdq#section/_96. Accessed on 9 28 2015.</ref>
*'''Stage I''' are microadenomas (<1 cm) without [[sella]] expansion
*'''Stage I''' involves microadenomas (<1 cm) without [[sella]] expansion
*'''Stage II''' are macroadenomas (≥1 cm) and may extend above the sella
*'''Stage II''' involves macroadenomas (≥1 cm) and may extend above the sella
*'''Stage III''' are macroadenomas with enlargement and invasion of the floor or suprasellar extension
*'''Stage III''' involves macroadenomas with enlargement and invasion of the floor or suprasellar extension
*'''Stage IV''' are macroadenomas that cause destruction of the sella
*'''Stage IV''' involves macroadenomas that cause destruction of the sella


==References==
==References==

Revision as of 13:01, 5 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

Pituitary adenoma may be classified according to the size of the adenoma and type of hormone secretion, subtypes include corticotrophic, somatotrophic, thyrotrophic, gonadotrophic, and lactrotrophic adenomas.

Classification

  • Historically, pituitary tumors were, historically, classified as basophilic, acidophilic, or chromophobic based on the positivity of hematoxylin and eosin stain.
  • Newer classification is based on either the size or the functional status of the adenoma (secretory vs. non-secretory).

Classification based on hormone secretion and immunohistochemical staining

Type of adenoma Secretion Staining Pathology
Corticotrophic adenomas secrete adrenocorticotropic hormone (ACTH) and pro-opiomelanocortin (POMC) basophilic Cushing's disease
Somatotrophic adenomas secrete growth hormone (GH) acidophilic acromegaly (gigantism)
Thyrotrophic adenomas (rare) secrete thyroid-stimulating hormone (TSH) basophilic occasionally hyperthyroidism, usually doesn't cause symptoms
Gonadotrophic adenomas secrete luteinizing hormone (LH), follicle-stimulating hormone (FSH) and their subunits basophilic usually doesn't cause symptoms
Lactrotrophic adenomas or prolactinomas (most common) secrete prolactin acidophilic galactorrhea, hypogonadism, amenorrhea, infertility, and impotence
Null cell adenomas do not secrete hormones may stain positive for synaptophysin

Classification based on the size of the adenoma

The radioanatomical classification places adenomas into 1 of 4 grades:

  • Stage I involves microadenomas (<1 cm) without sella expansion
  • Stage II involves macroadenomas (≥1 cm) and may extend above the sella
  • Stage III involves macroadenomas with enlargement and invasion of the floor or suprasellar extension
  • Stage IV involves macroadenomas that cause destruction of the sella

References

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