Pituitary adenoma classification: Difference between revisions

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| '''Type of adenoma''' || '''Secretion''' || '''Staining''' || '''Pathology'''  
| '''Type of adenoma''' || '''Secretion''' || '''Staining''' || '''Pathology'''  
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  | ''[[corticotrophic]] adenomas'' ||  secrete adrenocorticotropic hormone ([[ACTH]]) and pro-opiomelanocortin ([[POMC]]) || [[Anterior pituitary basophil|basophilic]] || [[Cushing's disease]]
  | ''[[Corticotrophic]] adenomas'' ||  secrete adrenocorticotropic hormone ([[ACTH]]) and pro-opiomelanocortin ([[POMC]]) || [[Anterior pituitary basophil|basophilic]] || [[Cushing's disease]]
  |-  
  |-  
  | ''[[somatotrophic]] adenomas'' ||  secrete growth hormone ([[GH]]) || [[Acidophile (histology)|acidophilic]] || [[acromegaly]] (gigantism)  
  | ''[[Somatotrophic]] adenomas'' ||  secrete growth hormone ([[GH]]) || [[Acidophile (histology)|acidophilic]] || [[acromegaly]] (gigantism)  
  |-  
  |-  
  | ''[[thyrotrophic]] adenomas'' (rare) ||  secrete thyroid-stimulating hormone ([[TSH]]) || [[Anterior pituitary basophil|basophilic]] || occasionally [[hyperthyroidism]]{{ref|thyrotrophic}}, usually doesn't cause symptoms
  | ''[[Thyrotrophic]] adenomas'' (rare) ||  secrete thyroid-stimulating hormone ([[TSH]]) || [[Anterior pituitary basophil|basophilic]] || occasionally [[hyperthyroidism]]{{ref|thyrotrophic}}, usually doesn't cause symptoms
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  |-  
  | ''[[gonadotrophic]] adenomas'' ||  secrete luteinizing hormone ([[LH]]), follicle-stimulating hormone ([[FSH]]) and their subunits || [[Anterior pituitary basophil|basophilic]] || usually doesn't cause symptoms
  | ''[[Gonadotrophic]] adenomas'' ||  secrete luteinizing hormone ([[LH]]), follicle-stimulating hormone ([[FSH]]) and their subunits || [[Anterior pituitary basophil|basophilic]] || usually doesn't cause symptoms
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  |-  
  | ''[[lactrotrophic]] adenomas'' or ''[[prolactinoma]]s'' (most common) ||  secrete [[prolactin]]  || [[Acidophile (histology)|acidophilic]] || [[galactorrhea]], [[hypogonadism]], [[amenorrhea]], [[infertility]], and [[impotence]]
  | ''[[Lactrotrophic]] adenomas'' or ''[[prolactinoma]]s'' (most common) ||  secrete [[prolactin]]  || [[Acidophile (histology)|acidophilic]] || [[galactorrhea]], [[hypogonadism]], [[amenorrhea]], [[infertility]], and [[impotence]]
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  |  ''[[null cell]] adenomas'' || do not secrete hormones || may stain positive for [[synaptophysin]] ||  
  |  ''[[Null cell]] adenomas'' || do not secrete hormones || may stain positive for [[synaptophysin]] ||  
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|}



Revision as of 18:12, 12 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pituitary adenomas are tumors that occur in the pituitary gland, and account for about 10% of intracranial neoplasms. They often remain undiagnosed, and small pituitary tumors are found in 6 to 24 percent of adults at autopsy. Pituitary adenomas arise within the anterior lobe (adenohypophysis) of the gland . Tumors less than 1 cm are called micro adenomas. Clinical symptoms depend on whether the tumor is secreting or nonsecreting. Nonsecreting adenomas grow and compress adjacent structures, most commonly causing a bitemporal hemianopsia due to chiasmatic compression. Lateral extension into the cavernous sinuses can result in cranial nerve palsies.

Classification

Pituitary tumors were, historically, classed as basophilic, acidophilic, or chromophobic on the basis of whether or not they took up the stains hematoxylin and eosin. This classification has fallen into disuse, in favor of a classification based on what type of hormone is secreted by the tumor (though tumors which do not secrete any active hormone ("non-functioning tumors") are still sometimes called "chromophobic"). At present, classification of pituitary tumors is based on plasma hormone levels or 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[2], 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

References

cs:Adenom hypofýzy nl:Hypofysetumor sk:Adenóm hypofýzy sv:Hypofystumör

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