Prolactinoma pathophysiology

Prolactinoma Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Prolactinoma may occur as part of a hereditary disorder called multiple endocrine neoplasia type 1 (MEN 1). A minority of prolactinomas are associated with Carney complex, McCune-Albright Syndrome, MEN like syndrome (CKDN1B loss of function).

Associated Diseases

Prolactinoma may occur as part of a hereditary disorder called multiple endocrine neoplasia type 1 (MEN 1). A minority of prolactinomas are associated with:

• Multiple endocrine neoplasia type I (MEN I)
• Carney complex
• McCune-Albright Syndrome
• MEN like syndrome (CKDN1B loss of function)

Familial pituitary adenomas

A pituitary adenoma may be part of a familial syndrome:

Syndrome	Gene	Notes
Multiple endocrine neoplasia I	MEN1	characterized by the 3 Ps: pituitary adenoma, parathyroid adenoma, pancreatic neuroendocrine tumor
MEN-1-like syndrome	CDKN1B	also known as Multiple endocrine neoplasia IV
Carney syndrome	PRKAR1A	other findings (mnemonic NAME): nevi, atrial myxoma, myxoid neurofibroma, ephelides (freckles)
Isolated pituitary adenoma	AIP	classically growth hormone-producing adenoma - leads to acromegaly

Microscopic Pathology

Features of prolactinoma include:

• Loss of fibrous stroma
• Normal (anterior) pituitary cells are nested

Notes:

• Smears very well

Stains

• Reticulin - loss of reticulin between tumor cells