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Tumors of the Pituitary Gland

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Surgical Pathology of Endocrine and Neuroendocrine Tumors

Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

Anterior pituitary tumors are clonal proliferation of pituitary cells. They usually consist of one cell type, although some adenomas consist of more than one cell type.

Pituitary tumors can be characterized by broad spectrum markers such as synaptophysin and chromogranin. Reticulin histochemical staining is useful in separating normal hyperplastic and neoplastic pituitary tissues. Electron microscopy is a powerful tool to help separate various subtypes of adenomas including sparsely and densely granulated growth hormone adenomas and different subtypes of silent ACTH adenomas.

The major types of pituitary adenomas include GH, PRL, ACTH, TSH, gonadotroph (FSH/LH), and null cell adenomas. A combination of hematoxylin and eosin staining, immunohistochemistry, and electron microscopic studies are the most comprehensive ways of classifying pituitary tumors.

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References

  1. Herbert E, Roberts J, Phillips M, Allen R, Hinman M, Budarf M, Policastro P, Rosa P. (1980) Biosynthesis, processing and release of corticotropin, β-endorphin, and melanocyte-stimulating hormone in pituitary cell culture systems. In: Martini L, Ganong WF (eds). Frontiers in Nueroendocrinology. Vol 6. New York, Raven pp. 67–101.

    Google Scholar 

  2. Landolt AM, Heitz PU. (1988) Differentiation of two types of amyloid occurring in pituitary adenomas. Pathol Res Pract 183:552–554.

    Article  PubMed  CAS  Google Scholar 

  3. Voight C, Saeger W, Gerigk C, Ludecke DK. (1988) Amyloid in pituitary adenomas. Pathol Res Pract 183:555–557.

    Article  Google Scholar 

  4. Lloyd RV, Cano M, Rosa P, Hille A, Huttner WB. (1988) Distribution of chromogranin and secretogranin I (chromogranin B) in neuroendocrine cells and tumors. Am J Pathol 130:296–304.

    PubMed  CAS  Google Scholar 

  5. Lloyd RV, Wilson BS, Kovacs K, Ryan N. (1985) Immunohistochemical localization of chromogranin in human hypophyses and pituitary adenomas. Arch Pathol Lab Med 109:515–547.

    PubMed  CAS  Google Scholar 

  6. Gould VE, Wiedenmann B, Lee I, Schwechheimer K, Dockhorn-Dworniczak B, Radosevich JA, Moll R, Franke WW. (1987) Synaptophysin expression in neuroendocrine neoplasm as determined by immunocytochemistry. Am J Pathol 126:243–257.

    PubMed  CAS  Google Scholar 

  7. DeLellis RA, Lloyd RV, Heitz PU, Eng C. (2004) Tumours of Pathology and Genetics of Tumors of Endocrine Organs: IARC Press Lyon pages 9–45.

    Google Scholar 

  8. Kovacs K, Lloyd R, Horvath E, Asa SL, Stefaneanu L, Killinger DW, Smyth S. (1989) Silent somatotroph adenomas of the human pituitary. A morphologic study of three cases including immunocytochemistry, electron microscopy, in vitro examination, and in situ hybridization. Am J Pathol 134:345–353.

    PubMed  CAS  Google Scholar 

  9. Kovacs K, Horvath E, Hartmannal WH, Sobin LH. (1986) Tumors of the pituitary gland. In: Atlas of Tumor Pathology. Fascicle 21. 2nd Series. Washington, DC, Armed Forces Institute of Pathology.

    Google Scholar 

  10. Horvath E, Kovacs K, Killinger DW, Smyth HS, Platts ME, Singer W. (1980) Silent corticotropic adenomas of the human pituitary gland: A histologic immunocytologic and ultrastructural study. Am J Pathol 98:617–638.

    PubMed  CAS  Google Scholar 

  11. Lloyd RV, Fields K, Jin L, Horvath E, Kovacs K, (1990) Analysis of endocrine active and clinically silent corticotroph adenomas by in situ hybridization. Am J Pathol 137:479–488.

    PubMed  CAS  Google Scholar 

  12. Duello T, Halmi NS. (1977) Endocrine and morphologic studies of pituitary adenomas secondary to primary hypothyroidism. J Clin Endocrinol Metab 45:903–911.

    Article  PubMed  Google Scholar 

  13. Katz MS, Gregerman RI, Horvath E, Kovacs K, Ezrin E. (1980) Thyrotroph cell adenoma of the human pituitary gland associated with primary hypothyroidism: Clinical and morphological features. Acta Endocrinol (Copenh) 95:41–48.

    CAS  Google Scholar 

  14. Afrasiabi A, Valenta L, Gwinup GA. (1979) A TSH-secreting pituitary tumour causing hyperthyroidism: presentation of a case and review of the literature. Acta Endocrinol (Copenh) 92:448–454.

    CAS  Google Scholar 

  15. Grisoli F, Leclerq T, Winteler JP, Jaquet P, Guibout M, Diaz-Vasquez P, Hassoun J, Nayak R. (1986) Thyroid-stimulating hormone pituitary adenomas and hyperthyroidism. Surg Neurol 25:361–368.

    Article  PubMed  CAS  Google Scholar 

  16. Horvath E, Kovacs K. (1984) Gonadotroph adenomas of the human pituitary: sex-related fine-structural dichotomy. A histologic, immunocytochemical, and electron-microscopic study of 30 tumors. Am J Pathol 117:429–440.

    CAS  Google Scholar 

  17. Landolt AM, Heitz PU. (1986) Alpha-subunit-producing pituitary adenomas. Immunocytochemical and ultrastructural studies. Virchows Arch (A) 409:417–431.

    Article  CAS  Google Scholar 

  18. Rindi G, Buffa R, Sessa F, Tortora O, Solcia E. (1986) Chromogranin A, B and C immunoreactivities of mammalian endocrine cells. Distribution, distinction from costored hormones/prohormones and relationship with the argyrophil component of secretory granules. Histochemistry 85:19–28.

    CAS  Google Scholar 

  19. Stefaneanu L, Ryan N, Kovacs K. (1988) Immunocytochemical localization of synaptophysin in human hypophyses and pituitary adenomas. Arch Pathol Lab Med 112:801–804.

    PubMed  CAS  Google Scholar 

  20. Lauriola L, Cocchia D, Sentinelli S, Maggiario N, Maira G, Michetti F. (1984) Immunohistochemical detection of folliculo-stellate cells in human pituitary adenomas. Virchows Arch (B) 47:189–197.

    Article  CAS  Google Scholar 

  21. Yamashita M, Qian ZR, Sano T, Horvath E, Kovacs K. (2005) Immunohistochemical study on so-called follicular cells and folliculostellate cells in the human adenohypophysis. Pathol Int. 55:244–247.

    Article  PubMed  Google Scholar 

  22. Barondes, SH, Cooper DN, Gitt MA, Leffler H. (1994) Galectins: structure and function of a large family of animal lectin. J Biol Chem 269:20807–20810.

    PubMed  CAS  Google Scholar 

  23. Amado M, Almeida R, Schwientek T, Clausen H. (1999) Identification and characterization of large galactosyltransferase gene familes: galactosyltransferases for all functions. Biochim Biophys Acta 1473:35–53.

    Article  PubMed  CAS  Google Scholar 

  24. Riss D, Jin L, Qian X, Bayliss J, Scheithauer BW, Young WF JR, Vidal S, Kovacs K, Raz A, Lloyd RV. (2003) Differential expression of galactin-3 in pituitary tumors. Cancer Res 63:2251–2255.

    PubMed  CAS  Google Scholar 

  25. Ironside IW, Royds JA, Jefferson AA, Timperley WR. (1987) Immunolocalization of cytokeratins in the normal and neoplastic human pituitary gland. J Neurol Neurosurg Psychiatry 50:57–65.

    Article  PubMed  CAS  Google Scholar 

  26. Hofler H, Denk H, Walter GF. (1984) Immunohistochemical demonstration of cytokeratins in endocrine cells of the human pituitary gland and in pituitary adenomas. Virchows Arch (A) 404:359–368.

    Article  CAS  Google Scholar 

  27. Neumann PE, Horoupian DS, Goldman JE, Hess MA. (1984) Cytoplasmic filaments of Crooke’s hyaline change belongs to the cytokeratin class. Am J Pathol 116:142–222.

    Google Scholar 

  28. Gerdes J, Li L, Schlueter C, et al. (1991) Immunobiochemical and molecular biologic characterization of the cell proliferation-associated nuclear antigen that is defined by monoclonal antibody Ki-67. Am J Pathol 138:867.

    PubMed  CAS  Google Scholar 

  29. Thapar K, Kovacs K, Scheithauer BW, et al. (1996) Proliferative activity and invasiveness among pituitary adenomas and carcinomas: an analysis using the MIB-1 antibody. Neurosurgery 38:99–106.

    Article  PubMed  CAS  Google Scholar 

  30. Yamada S, Ohyama K, Taguchi M, Takeshita A, Morita K, Takano K, Sano T. (2007) A study of the correlation between morphological findings and biological activities in clinically nonfunctioning pituitary adenomas. Neurosurgery 61:580–584.

    Article  PubMed  Google Scholar 

  31. Hollstein M, Sidransky D, Vogelstein B, et al. (1991) P53 mutations in human cancers. Science 253:49.

    Article  PubMed  CAS  Google Scholar 

  32. Hosoi G, Hara J, Okamura T, et al. (1994) Low frequency of the p53 gene mutations in neuroblastoma. Cancer 73:3087.

    Article  PubMed  CAS  Google Scholar 

  33. Scheithauer BW, Gaffey TA, Lloyd RV, Sebo TJ, Kovacs KT, Horvath E, Yapicier O, Young WF Jr, Meyer FB, Kuroki T, Fiehle DL, Laws ER Jr. (2006) Pathobiology of pituitary adenomas and carcinomas. Neurosurgery 59:341–253.

    Article  PubMed  Google Scholar 

  34. Tanizaki Y, Jin L, Scheithauer BW, Kovacs K, Roncaroli F, Lloyd RV. (2007) P53 gene mutations in pituitary carcinomas. Endocr Pathol 18:217–222.

    Article  PubMed  CAS  Google Scholar 

  35. Asa SL. (1997) Tumors of the Pituitary Gland. In Atlas of Tumor Pathology. Fascicle 22 3rd ed. Washington, DC: Armed Forces Institute of Pathology.

    Google Scholar 

  36. Horvath E, Kovacs K. (1992) Ultrastructural diagnosis of human pituitary adenomas. Microsc Res Techn 20:107–135.

    Article  CAS  Google Scholar 

  37. Horvath E. (1994) Ultrastructural markers in the pathologic diagnosis of pituitary adenomas. Ultrastruct Pathol 18:171–179.

    Article  PubMed  CAS  Google Scholar 

  38. Horvath E, Kovacs K, Scheithauer BW. (1999) Pituitary hyperplasia. Pituitary. 1:169–170.

    Article  PubMed  CAS  Google Scholar 

  39. Horvath E, Kovacs K. (1993) Ultrastructural diagnosis of pituitary adenomas and hyperplasias. In: Lloyd RV (ed). Surgical Pathology of the Pituitary Gland. Major Problems in Pathology. Philadelphia, Saunders, pp. 52–84.

    Google Scholar 

  40. Crooke A. (1935) A change in the basophil cells of the pituitary gland common to conditions which exhibit the syndrome attributed to basophil adenoma. J Pathol Bacteriol 41:339–349.

    Article  Google Scholar 

  41. Horvath E, Kovacs K, Jossse R. (1983) Pituitary corticotroph cell adenoma with marked abundance of microfilaments. Ultrastruct Pathol 5:249–255.

    Article  PubMed  CAS  Google Scholar 

  42. Neumann PE, Horoupian DS, Goldman JE, Hess MA. (1984) Cytopasmic filaments of Crooke’s hyaline change belong to the cytokeratin class. An immunocytochemical and ultrastructural study. Am J Pathol 116:214–222.

    CAS  Google Scholar 

  43. Girod C, Trouillas J, Claustrat B. (1986) The human thyrotropic adenoma: pathologic diagnosis in five cases and critical review of the literature. Semin Diagn Pathol 3:58–68.

    PubMed  CAS  Google Scholar 

  44. Beck-Peccoz P, Piscitelli G, Amr S, et al. (1986) Endocrine, biochemical, and morphological studies of a pituitary adenoma secreting growth hormone, thyrotropin (TSH), and alpha-subunit: evidence for secretion of TSH with increased bioactivity. J Clin Endocrinol Metab 62:704–711.

    Article  PubMed  CAS  Google Scholar 

  45. Beck-Peccoz P, Brucker-Davis F, Persani L, Smallridge RC, Weintraub BD. (1996) Thyrotropin-secreting pituitary tumors. Endocr Rev 17:610–638.

    PubMed  CAS  Google Scholar 

  46. Kontogeorgos G, Horvath E, Kovacs K. (1990) Sex-linked ultrastructural dichotomy of gonadotroph adenomas of the human pituitary: an electron microscopic analysis of 145 tumors. Ultrasatruct Pathol 14:475–482.

    Article  CAS  Google Scholar 

  47. Scheithauer BW, Horvath E, Kovacs K, Laws ER Jr, Randall RV., Ryan N. (1986) Plurihormonal pituitary adenomas. Semin Diagn Pathol 3:69–82.

    PubMed  CAS  Google Scholar 

  48. Matsumo A, Sasaki T, Kirino T. (1999) Plurihormonal pituitary tumor. J Neurosurg 90:608–609.

    Google Scholar 

  49. Osamura RY, Egashira N, Miyai S, Yamazaki M, Takekoski S, Sammo N, Teramoto A. (2004) Molecular pathology of the pituitary. Development and functional differentiation of pituitary adenomas. Front Horm Res 32:20–33.

    CAS  Google Scholar 

  50. Asa SL, Ezsat S. (2004) Molecular basis of pituitary development and cytogenesis. Front Horm Res 32:1–19.

    Article  PubMed  CAS  Google Scholar 

  51. Saeger W, Ludecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. (2007) Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol 156:203–216.

    Article  PubMed  CAS  Google Scholar 

  52. Kontogeorgos G. (2005) Classification and pathology of pituitary tumors. Endocrine 28:27–35.

    Article  PubMed  CAS  Google Scholar 

  53. Molitch ME, Gillam MP. (2007) Lymphocytic hypophysitis. Horm Res 68(Suppl 5):145–150.

    Article  PubMed  Google Scholar 

  54. Caturegli P, Newschaffer C, Olivi A, Pomper MG, Burger PC, Rose NR. (2005) Autoimmune hypophysitis. Endocr Rev 26:599–614.

    Article  PubMed  CAS  Google Scholar 

  55. Glezer A, Paraiba DB, Bronstein MD. (2008) Rare sellar lesion. Endocrinol Metab Clin North Am 37:195–211.

    Article  PubMed  Google Scholar 

  56. Bihan H, Christozova V, Dumas JL, Jomaa R, Valeyre D, Tazi A, Reach G, Krivitzky A, Cohen R. (2007) Sarcoidosis: clinical, hormonal, and magnetic resonance imaging (MRI) manifestations of hypothalamic-pituitary disease in 9 patients and review of the literature. Medicine (Baltimore) 86:259–268.

    Article  Google Scholar 

  57. Miyoshi T, Otsuka F, Takeda M, Inagaki K, Otani H, Ogura T, Ichiki K, Amano T, Makino H. (2007) An elderly patient with sarcoidosis manifesting panhypopituitarism with central diabetes insipidus. Endocr J 54:425–430.

    Article  PubMed  Google Scholar 

  58. Roncaroli F, Scheithauer BW, Cenachi G, Horvath E, Kovacs K, Lloyd RV, Abell-Aleff P, Santi M, Yates AJ. (2002) ‘Spindle cell oncocytoma’ of the adenohypophysis: a tumor of folliculostellate cells? Am J Surg Pathol 26:1048–1055.

    Article  Google Scholar 

  59. Vaitai I, Sahli R, Kappeler A. (2006) Spindle cell oncocytoma of the adenohypophysis: report of a case with a 16-year follow-up. Pathol Res Pract 202:745–750.

    Article  Google Scholar 

  60. Figarella-Branger D, Dufour H, Fernandez C, Bourier-Labit C, Grisoli F, Pellissier JF. (2002). Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis: report of three cases. Acta Neuropathol 104:313–319.

    CAS  Google Scholar 

  61. Mahnel R, Tan KH, Fahlbusch R, Volk B, Ludecke D, Nagel HG, Jaursch-Hancke C. (2002) Problems in differential diagnosis of non Langerhans cell histiocytosis with pituitary involvement: case report and review of literature. Endocr Pathol 13:361–368.

    Article  PubMed  Google Scholar 

  62. Karavitaki N, Wass JA. (2008) Craniopharyngiomas. Endocrinol Metab Clin North Am 37:173–193.

    Article  PubMed  CAS  Google Scholar 

  63. Garre ML, Cama A. (2007) Craniopharyngioma: modern concepts in pathogenesis and treatment. Curr Opin Pediatr 19:471–479.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA

    Ricardo V. Lloyd (Professor of Pathology and Laboratory Medicine)

  2. Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, USA, MN 55905

    Bernd W. Scheithauer

  3. Department of Pathology, St Michael’s Hospital, Toronto, Ontario, CA, USA

    Eva Horvath & Kalman Kovacs

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  1. Ricardo V. Lloyd
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  2. Bernd W. Scheithauer
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  3. Eva Horvath
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  4. Kalman Kovacs
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Correspondence to Ricardo V. Lloyd .

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  1. School (UMMS), University of Massachusetts Medical, Lake Avenue N. 55, Worcester, 01655, U.S.A.

    Ashraf Khan

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Lloyd, R.V., Scheithauer, B.W., Horvath, E., Kovacs, K. (2009). Tumors of the Pituitary Gland. In: Khan, A. (eds) Surgical Pathology of Endocrine and Neuroendocrine Tumors. Current Clinical Pathology. Humana Press. https://doi.org/10.1007/978-1-60327-396-1_4

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  • DOI: https://doi.org/10.1007/978-1-60327-396-1_4

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