Pituitary adenoma pathophysiology

Pituitary adenoma Microchapters
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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.

Pathophysiology

• Pathological feature

• The radioanatomical classification places adenomas into 1 of 4 grades:

• Stage I involve microadenomas (<1 cm) without sellar expansion.
• Stage II involve macroadenomas (≥1 cm) and may extend above the sella.
• Stage III involve macroadenomas with enlargement and invasion of the floor or suprasellar extension.
• Stage IV involve macroadenomas that cause destruction of the sella.

• Microadenoma

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

• 

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

• *Larger adenomas can lead to hormonal imbalance due to mass effect rather than secretion.
• *Macroadenomas are approximately twice as common as micoadenoma.
• 

  Histopathological image of nonfunctioning pituitary adenoma. Hematoxylin & eosin stain.