Please enable JavaScript.
Coggle requires JavaScript to display documents.
Diseases of Pituitary and Pineal Glands - Coggle Diagram
Diseases of Pituitary and Pineal Glands
Pituitary Gland
Structure
Anterior pituitary
Adenohypophysis
GH
PRL
ACTH
TSH
FSH
LH
Posterior pituitary
Neurohypophysis
ADH / vasopressin
Oxycotin
Pituitary Stalk
Connects pituitary and hypothalamus
Functions
Maintain equilibrium via the production of hormones
Adenohypophysis
Acidophil cells
Somatatrophs (GH)
Lacatotrophs (PRL)
Basophil cells
Corticotrophs (ACTH)
Thyrotrophs / Gonadotrophs (TSH/FSH/LH)
Chromophobe cells
Neurohypophysis
Neural Tissue
Pituitary Hypofunction
Pathogenesis
Infarction
Post partum (Sheehan syndrome)
Sickle cell disease
Temporal arteritis
Diabetes Mellitus
Cavernous sinus thrombosis
Disseminated intravascular coagulation
Compression
Non-functional tumour (PitNETs /adenoma)
Craniopharyngioma (solid / mixed solid-cystic benign tumour)
Teratoma
Infection
TB
Meningitis
Signs / Symptoms
GH deficiency
LH / FSH deficiency
TSH deficiency
ACTH deficiency
PRL deficiency
ADH deficiency
Pituitary Neuroendocrine Tumours (PiNET) / Adenoma
Classification
Size + Cell Origin
Size
Microadenoma <10mm
Macroadenoma >10mm
Cell Types
Somatotroph
Lactotroph
Thyrotroph
Corticotroph
Gonadotroph
Presentation
Hormone deficiency or excess
Mass Effects
Local compressive effects on optic chiasm
Bitemporal hemianopia
Headaches
Pituitary apoplexy
(sudden haemorrhage into
adenoma, with excruciating headache and
diplopia
Generally benign tumours of the anterior pituitary
Rarely locally invade and metastasise
Hormonal Effects
Hormone overproduction with normal levels of other hormones
Hormones overproduction with reduced prodution of other hormones
Pressure atrophy of gland with panhypopituitarism (non-functioning)
Syndromes
Acromegaly ↑GH
Cushings Disease ↑ACTH
Empty Sella Syndrome - clinical pitutary hypofunction
Diabetes Insipidus ↓ADH
Pineal Gland
Structure
Stroma and pineocytes
Photosensory and neuroendocrine
Function
Melatonin secretion
Tumours
Germ cell Tumours
Yolk sack tumours
Teratomas
Choriocarcinoma
Pineal Parenchymal tumours
Pineoblastoma
Epidemiology
Worse prognosis in young children
Infants and young children
35% of all pineal parenchymal tumours
Genes
DICER1 germline mutations strongly associated
Altered retinoblsatoma-1 gene worst prognosis + mets
Morphology
Large
Invasive
Obstructive hydrocephalus
Craniospinal dissemination
Pineocytoma
Benign Lesions
Cysts
Vascular Malformations
DICER1-Related Tumour Predisposition Syndromes
Genetics
Autosomal dominant
Encodes MicroRNA processing enzyme
Tumour Locations
Bening and malignant tumours
Brain
Eye
Nose
Thyroid
Lung
Liver
GIT
Peritoneum
Ovary
Fallopian tube
Associated Tumours
Pleuropulmonary blastoma
Thyroid cancers
Paediatric cystic nephroma
Embryonal rhabdomyosarcoma of the uterine cervix
Pineoblastoma
Pituitary blastoma
Sheehan Syndrome
Definition
Pituitary infarction and necrosis following post-partum hypotension or shock
Pathogenesis
Hypotension/shock due to haemorrhage post-partum
Reduced oxygenation of pituitary gland
Necrosis and long term damage to pituitary gland
Risk Factors
Multiple pregnancies
Twins / triplets
Abnormal placenta adherenec
Pre-eclampsia
Hypertension
Clotting disoreders
Presentation
Agalactorrhoea
Menstrual irregularities - Amenorrhoes
Oligomenorrhoea
Adrenal insufficiency
Hypothyroidism
Diabetes insipidus
Optic Chiasm compression and visual field loss
Ophthalmoplegia
