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(anterior) PITUITARY PATHOLOGY, past functional classification - Coggle…
(anterior) PITUITARY PATHOLOGY
general info
Size 1 x 0.5 cm
Weight 400-900 mg
Normal hystology: adeno/neuro
Cellular types: GH 50%, PRL 15%, ACTH 15%, FSH/LH 10%, null 10%
Linked to the hypothalamus, which regulatespituitary functions via hormones released by neural axons and in the blood (portal veins)
histochemical staining with RETICULIN
architecture examination
small alveoli with reticulin nerwork
normal tissue
large alveoli / disruption of reticulin network
probable neoplastic
causes
congenital
Rathke cleft
inflammatory
acute
leptomeningitisc
chronic
TBC
sarcoidosis
diabetes insipidus
lymphocytic autoimmune
infiltrative
amyloidosis
one of the most common causes of hypopituitarism
hemochromatosis
histiocytosis X
mucopolysaccaridosis
necrosis
focal
massive
shock
CID
post-partum
Sheehan syndrome
lesions
functional classification
functioning
hormone over-secretion
non-functioning
mass effect
bigger lesions
generally, removed with a transsphenoidal approach
very small samples
no data obtained through macroscopic observation
DD
metastases
germinal tumors
tumors of the neurohypophysis
bone sarcomas
histiocytosis X
myeloma
chordoma
PITUITARY ADENOMA
classifications
WHO 2022:
"pituitary neuroendocrine tumor"
no division between benign and malignant lesions
2017-2021
"transcriptional classification"
IHC algorithm
transcription factors
hormonal secretion
good clinical course assessment
(more or less aggressive)
hereditary conditions
syndromic diseases
CDKN18
SHD-related paraganglioma/pheochromocytoma
MEN1
NF1
DICER1
isolated pituitary disease
AIP
GPR101
unknown in the case of familial isolated pituitary adenoma
PITUITARY CARCINOMA
WHO 2022:
"metastatic pituitary NE tumor"
diagnosis can be made only in the presence of two types of metastases
distant
endocrine tumor close to blood vessels
lung, liver, lymph nodes
intracranial
tumor spreading to the spine
microscopic features
similar to an adenoma
prominent atypia
increased mitotic and proliferation indices
necrosis may occur
CRANIOPHARYNGIOMA
pituitary tumor, not endocrine
congenital anomalies
more common in children
very heterogeneous
morphological distinction
papillary
more epithelial (glandular)
better behavior
clinically benign
BRAF mutation
adenomantinomatous
less differentiated
no glandular structure
more aggressive
beta catenin mutation
past functional classification
histochemical
acidophilic
basophilic
hormonal