Pituitary apoplexy pathophysiology: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 31: Line 31:
==Microscopic Feautres==
==Microscopic Feautres==
*Electron microscopic shows evidence of abnormal fenestration of tumor vessels (pituitary adenoma) with fragmented basal membranes that may predispose to hemorrhage.
*Electron microscopic shows evidence of abnormal fenestration of tumor vessels (pituitary adenoma) with fragmented basal membranes that may predispose to hemorrhage.
[[File:Nonfunctioning pituitary adenoma (1).jpg]]
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 18:11, 24 July 2017

Pituitary apoplexy Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Pituitary apoplexy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X-ray

Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pituitary apoplexy pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pituitary apoplexy pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pituitary apoplexy pathophysiology

CDC on Pituitary apoplexy pathophysiology

Pituitary apoplexy pathophysiology in the news

Blogs on Pituitary apoplexy pathophysiology

Directions to Hospitals Treating Pituitary apoplexy

Risk calculators and risk factors for Pituitary apoplexy pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Pituitary apoplexy is an acute clinical syndrome caused by hemorrhage and necrosis in the pituitary gland. Most commonly it is associated with pituitary adenoma.

Pathophysiology

Pituitary apoplexy is caused by bleeding into pituitary gland.


Genetics

  • Gene involved in the pathogenesis of pituitary apoplexy include mutation in AIP gene, which is located on chromosome 11q13.2
  • The most common mutation site in AIP gene is p.R304 locus.
  • Mutated AIP loses its activity as a tumor supressor gene and leads to increased proliferation.
  • The penetration of AIP postive carriers is 12-30%.

Associated Conditions

Pituitary apoplexy is seen with 0.6 to 10% of pituitary adenomas.

Gross Pathology

  • The predominant finding is hemorrhage with or without necrosis.
  • Pale, necrotic material was particularly found when there was a long interval between the acute clinical event and surgery.


Microscopic Feautres

  • Electron microscopic shows evidence of abnormal fenestration of tumor vessels (pituitary adenoma) with fragmented basal membranes that may predispose to hemorrhage.

References

  1. Zayour DH, Selman WR, Arafah BM (2004). "Extreme elevation of intrasellar pressure in patients with pituitary tumor apoplexy: relation to pituitary function". J Clin Endocrinol Metab. 89 (11): 5649–54. doi:10.1210/jc.2004-0884. PMID 15531524.
  2. Oldfield EH, Merrill MJ (2015). "Apoplexy of pituitary adenomas: the perfect storm". J Neurosurg. 122 (6): 1444–9. doi:10.3171/2014.10.JNS141720. PMID 25859802.
  3. Schechter J (1972). "Ultrastructural changes in the capillary bed of human pituitary tumors". Am J Pathol. 67 (1): 109–26. PMC 2032586. PMID 5055626.
  4. Schechter J, Goldsmith P, Wilson C, Weiner R (1988). "Morphological evidence for the presence of arteries in human prolactinomas". J Clin Endocrinol Metab. 67 (4): 713–9. doi:10.1210/jcem-67-4-713. PMID 3417848.

Template:WH Template:WS