Pituitary adenoma pathophysiology: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(8 intermediate revisions by 3 users not shown)
Line 6: Line 6:
==Pathology==
==Pathology==
===Pathological feature===
===Pathological feature===
*The radioanatomical classification places adenomas into 1 of 4 grades:<small><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></small>
Pituitary adenoma may be classified into 4 grades based on radioanatomical findings:<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''' involves microadenomas (<1 cm) without [[sella]]r expansion
*'''Stage I''' involves microadenomas (<1 cm) without [[sella]] expansion
:*'''Stage II''' involves macroadenomas (≥1 cm) and may extend above the sella
*'''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 III''' involves macroadenomas with enlargement and invasion of the floor or suprasellar extension
:*'''Stage IV''' involves macroadenomas that cause destruction of the sella
*'''Stage IV''' involves macroadenomas that cause destruction of the sella
 
===Microadenoma===
===Microadenoma===
:*Pituitary microadenomas are defined as adenomas less than 10 mm in size.<small><ref name=Radiopaedia> pituitary micro adenoma Dr Amir Rezaee and Dr Frank Gaillard. 2015 http://radiopaedia.org/articles/pituitary-microadenoma</ref></small>
:*Pituitary microadenomas are defined as adenomas less than 10 mm in size.<small><ref name=Radiopaedia> pituitary micro adenoma Dr Amir Rezaee and Dr Frank Gaillard. 2015 http://radiopaedia.org/articles/pituitary-microadenoma</ref></small>
Line 23: Line 24:
===Macroadenoma===
===Macroadenoma===
*Pituitary macroadenomas are the most common [[suprasellar]] mass in adults.<small><ref name=radio>Pituitary adenoma. Dr Amir Rezaee and Dr Yuranga Weerakkody. Radiopaedia.org 2015.http://radiopaedia.org/articles/pituitary-adenoma</ref></small>
*Pituitary macroadenomas are the most common [[suprasellar]] mass in adults.<small><ref name=radio>Pituitary adenoma. Dr Amir Rezaee and Dr Yuranga Weerakkody. Radiopaedia.org 2015.http://radiopaedia.org/articles/pituitary-adenoma</ref></small>
*They are defined as adenomas greater than 10 mm in size and are most frequently diagnosed due to compression of the surrounding structures, such as [[optic chiasm]].
*They are defined as adenomas greater than 10 mm in size and are most frequently diagnosed due to compression of the surrounding structures, such as the [[optic chiasm]].
*Larger adenomas can lead to hormonal imbalance due to mass effect rather than secretion.
*Larger adenomas can lead to hormonal imbalance due to mass effect rather than secretion.
*[[Hypopituitarism]] or moderately elevated [[prolactin]] are both seen, the later due to stalk effect. Prolactin release (unlike other pituitary hormones) is tonically inhibited by prolactin inhibitory hormone (a.k.a. dopamine) and as such compression of the pituitary infundibulum can result in elevation of systemic prolactin levels due to interruption of normal inhibition.
*[[Hypopituitarism]] or moderately elevated [[prolactin]] are both seen, the latter due to stalk effect. Prolactin release (unlike other pituitary hormones) is tonically inhibited by prolactin inhibitory hormone ([[dopamine]]) and as such compression of the pituitary infundibulum can result in elevation of systemic prolactin levels due to interruption of normal inhibition.
*Macroadenomas are approximately twice as common as micoadenoma.
*Macroadenomas are approximately twice as common as micoadenoma.
====Gross Pathology====
====Microscopic Pathology====
====Microscopic Pathology====
<Gallery>
<Gallery>
Line 41: Line 41:
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Neurology]]
[[Category:Neurosurgery]]
[[Category:Endocrinology]]

Latest revision as of 14:11, 26 May 2019

Pituitary adenoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pituitary adenoma from other Diseases

Epidemiology and Demographics

Risk Factors

Natural history, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

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 adenoma pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pituitary adenoma 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 adenoma pathophysiology

CDC on Pituitary adenoma pathophysiology

Pituitary adenoma pathophysiology in the news

Blogs on Pituitary adenoma pathophysiology

Directions to Hospitals Treating Pituitary adenoma

Risk calculators and risk factors for Pituitary adenoma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

On gross pathology, a well circumscribed suprasellar mass is a characteristic finding of pituitary adenoma. On microscopic histopathological analysis, a monomorphic expansion of usually one cell type with lack of reticulin network among neoplastic cells is a characteristic finding of pituitary adenoma.

Pathology

Pathological feature

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

  • 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

Microadenoma

  • Pituitary microadenomas are defined as adenomas less than 10 mm in size.[1]
  • Most frequently diagnosed as a result of investigating hormonal imbalance.
  • They are confined to the sella and have no scope to produce mass effect related symptoms.

Microscopic Pathology

  • Histopathological image of pituitary adenoma with GH production. Acidophilic cell type. Hematoxylin & esoin stain.[2]

    Histopathological image of pituitary adenoma with GH production. Acidophilic cell type. Hematoxylin & esoin stain.[2]

  • Histopathological image of pituitary adenoma with GH production. Acidophilic cell type. Hematoxylin & esoin stain.[2]

    Histopathological image of pituitary adenoma with GH production. Acidophilic cell type. Hematoxylin & esoin stain.[2]

Macroadenoma

  • Pituitary macroadenomas are the most common suprasellar mass in adults.[3]
  • They are defined as adenomas greater than 10 mm in size and are most frequently diagnosed due to compression of the surrounding structures, such as the optic chiasm.
  • Larger adenomas can lead to hormonal imbalance due to mass effect rather than secretion.
  • Hypopituitarism or moderately elevated prolactin are both seen, the latter due to stalk effect. Prolactin release (unlike other pituitary hormones) is tonically inhibited by prolactin inhibitory hormone (dopamine) and as such compression of the pituitary infundibulum can result in elevation of systemic prolactin levels due to interruption of normal inhibition.
  • Macroadenomas are approximately twice as common as micoadenoma.

Microscopic Pathology

  • Histopathological image of nonfunctioning pituitary adenoma. Hematoxylin & eosin stain.[4]

    Histopathological image of nonfunctioning pituitary adenoma. Hematoxylin & eosin stain.[4]

References

  1. ↑ pituitary micro adenoma Dr Amir Rezaee and Dr Frank Gaillard. 2015 http://radiopaedia.org/articles/pituitary-microadenoma
  2. ↑ 2.0 2.1 https://en.wikipedia.org/wiki/Pituitary_adenoma#/media/File:Pituitary_adenoma_%281%29_GH_production.jpg
  3. ↑ Pituitary adenoma. Dr Amir Rezaee and Dr Yuranga Weerakkody. Radiopaedia.org 2015.http://radiopaedia.org/articles/pituitary-adenoma
  4. ↑ https://en.wikipedia.org/wiki/Pituitary_adenoma#/media/File:Nonfunctioning_pituitary_adenoma_%281%29.jpg

Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Pituitary_adenoma_pathophysiology&oldid=1569758"