Pituitary adenoma classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pituitary adenomas are tumors that occur in the pituitary gland, and account for about 10% of intracranial neoplasms. They often remain undiagnosed, and small pituitary tumors are found in 6 to 24 percent of adults at autopsy. Pituitary adenomas arise within the anterior lobe (adenohypophysis) of the gland . Tumors less than 1 cm are called micro adenomas. Clinical symptoms depend on whether the tumor is secreting or nonsecreting. Nonsecreting adenomas grow and compress adjacent structures, most commonly causing a bitemporal hemianopsia due to chiasmatic compression. Lateral extension into the cavernous sinuses can result in cranial nerve palsies.
Classification
Pituitary tumors were, historically, classed as basophilic, 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"). At present, classification of pituitary tumors is based on plasma hormone levels or immunohistochemical staining:
| Type of adenoma | Secretion | Staining | Pathology |
| corticotrophic adenomas | secrete adrenocorticotropic hormone (ACTH) and pro-opiomelanocortin (POMC) | basophilic | Cushing's disease |
| somatotrophic adenomas | secrete growth hormone (GH) | acidophilic | acromegaly (gigantism) |
| thyrotrophic adenomas (rare) | secrete thyroid-stimulating hormone (TSH) | basophilic | occasionally hyperthyroidism[2], usually doesn't cause symptoms |
| gonadotrophic adenomas | secrete luteinizing hormone (LH), follicle-stimulating hormone (FSH) and their subunits | basophilic | usually doesn't cause symptoms |
| lactrotrophic adenomas or prolactinomas (most common) | secrete prolactin | acidophilic | galactorrhea, hypogonadism, amenorrhea, infertility, and impotence |
| null cell adenomas | do not secrete hormones | may stain positive for synaptophysin |
References
cs:Adenom hypofýzy nl:Hypofysetumor sk:Adenóm hypofýzy sv:Hypofystumör