Pituitary adenoma classification: Difference between revisions

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Latest revision as of 19:32, 2 October 2019

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 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	Adrenocorticotropic hormone (ACTH) and pro-opiomelanocortin (POMC)	Basophilic	Cushing's disease
Somatotrophic adenomas	Growth hormone (GH)	Acidophilic	Acromegaly (gigantism)
Thyrotrophic adenomas (rare)	Thyroid-stimulating hormone (TSH)	Basophilic	Occasionally hyperthyroidism/Asymptomatic
Gonadotrophic adenomas	Luteinizing hormone (LH), follicle-stimulating hormone (FSH) and their subunits	Basophilic	Asymptomatic
Lactrotrophic adenomas or prolactinomas (most common)	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

Pituitary adenoma may be classified into 4 grades based on radioanatomical:

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

Template:WikiDoc Sources

@@ Line 4: / Line 4: @@
 ==Overview==
-Pituitary adenoma may be classified according to the size of the adenoma and hormone secretion, subtypes include [[corticotrophic]] adenomas, [[somatotrophic]] adenomas, [[thyrotrophic]] adenomas, [[gonadotrophic]] adenomas, and [[lactrotrophic]] adenomas.
+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==
-Pituitary tumors were, historically, classified as [[basophilic]], [[Acidophile|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").
+*Historically, pituitary tumors were classified as [[basophilic]], [[acidophile|acidophilic]], or [[chromophobic]] based on the positivity of [[hematoxylin]] and [[eosin]] stain.
-At present, classification of pituitary tumors is based on size, plasma hormone levels, or [[immunohistochemical staining]].
+*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===
 {| class="wikitable"
@@ Line 16: / Line 15: @@
 |! style="background: #4479BA; color:#FFF;" |'''Pathology'''
   |-
-| style="background: #F0F0F0;" align=center |''[[Corticotrophic]] ''adenomas ||  secrete adrenocorticotropic hormone ([[ACTH]]) and pro-opiomelanocortin ([[POMC]]) || [[Anterior pituitary basophil|basophilic]] || [[Cushing's disease]]
+| style="background: #F0F0F0;" align=center |''[[Corticotrophic]] ''adenomas ||[[Adrenocorticotropic hormone]] ([[ACTH]]) and [[pro-opiomelanocortin]] ([[POMC]]) ||[[Anterior pituitary basophil|Basophilic]] || [[Cushing's disease]]
   |-
-| style="background: #F0F0F0;" align=center |[[Somatotrophic]] adenomas'' ||  secrete growth hormone ([[GH]]) || [[Acidophile (histology)|acidophilic]] || [[acromegaly]] (gigantism)
+| style="background: #F0F0F0;" align=center |[[Somatotrophic]] adenomas'' ||[[Growth hormone]] ([[GH]]) ||[[Acidophile (histology)|Acidophilic]] || [[Acromegaly]] ([[gigantism]])
   |-
-| style="background: #F0F0F0;" align=center |[[Thyrotrophic]] ''adenomas (rare) ||  secrete thyroid-stimulating hormone ([[TSH]]) || [[Anterior pituitary basophil|basophilic]] || occasionally [[hyperthyroidism]], usually doesn't cause symptoms
+| style="background: #F0F0F0;" align=center |[[Thyrotrophic]] ''adenomas (rare) ||[[Thyroid-stimulating hormone]] ([[TSH]]) ||[[Anterior pituitary basophil|Basophilic]] || Occasionally [[hyperthyroidism]]/[[Asymptomatic]]
   |-
-| style="background: #F0F0F0;" align=center |''[[Gonadotrophic]] ''adenomas ||  secrete luteinizing hormone ([[LH]]), follicle-stimulating hormone ([[FSH]]) and their subunits || [[Anterior pituitary basophil|basophilic]] || usually doesn't cause symptoms
+| style="background: #F0F0F0;" align=center |''[[Gonadotrophic]] ''adenomas ||[[Luteinizing hormone]] ([[LH]]), [[follicle-stimulating hormone]] ([[FSH]]) and their subunits ||[[Anterior pituitary basophil|Basophilic]] ||[[Asymptomatic]]
   |-
-| style="background: #F0F0F0;" align=center |''[[Lactrotrophic]] adenomas'' or ''[[prolactinoma]]s'' (most common) ||  secrete [[prolactin]]  || [[Acidophile (histology)|acidophilic]] || [[galactorrhea]], [[hypogonadism]], [[amenorrhea]], [[infertility]], and [[impotence]]
+| style="background: #F0F0F0;" align=center |''[[Lactrotrophic]] adenomas'' or ''[[prolactinoma]]s'' (most common) || [[Prolactin]]  || [[Acidophile (histology)|Acidophilic]] || [[Galactorrhea]], [[hypogonadism]], [[amenorrhea]], [[infertility]], and [[impotence]]
   |-
-| style="background: #F0F0F0;" align=center |''[[Null cell]] adenomas'' || do not secrete hormones || may stain positive for [[synaptophysin]] ||
+| style="background: #F0F0F0;" align=center |''[[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 stages:<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>
+Pituitary adenoma may be classified into 4 grades based on radioanatomical:<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 turcica|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 tumors|suprasellar]] extension
-*'''Stage IV''' are macroadenomas that cause destruction of the sella
+*'''Stage IV''' involves macroadenomas that cause destruction of the [[Sella turcica|sella]]
 ==References==
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 [[Category:Endocrinology]]
 [[Category:Mature chapter]]
+ [[Category:Up-To-Date]]
+[[Category:Oncology]]
+[[Category:Medicine]]
+[[Category:Neurology]]
+[[Category:Neurosurgery]]
+[[Category:Endocrinology]]