Pituitary gland - Revision history

Jensflorian: /* Pituitary carcinoma */ Update

2022-09-30T11:30:26Z

Pituitary carcinoma: Update

← Older revision		Revision as of 11:30, 30 September 2022
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	==Pituitary carcinoma==		==Pituitary carcinoma==
	* ~~ICD-O: 8272/3~~		* Depreceated in the WHO2022 classification.
	* Requires presence of cerebrospinal or systemic metastasis.		* It is acknowledged that PitNETs can be invasive or spread to other sites.
	* Very rare.
	* ~~75% are hormonally active (mostly PRL~~ or ~~ACTH)~~.
	* IHC: Synaptophysin, Chromogranin +ve

	==Rathke cleft cyst==		==Rathke cleft cyst==

Jensflorian: /* Pituitary neuroendocrine tumor (PitNET) */ Update

2022-09-30T11:28:44Z

Pituitary neuroendocrine tumor (PitNET): Update

← Older revision		Revision as of 11:28, 30 September 2022
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	*Sparsely granulated somatotroph adenomas are more invasive than other variants and respond less to medical treatment. <ref>{{Cite journal \| last1 = Kato \| first1 = M. \| last2 = Inoshita \| first2 = N. \| last3 = Sugiyama \| first3 = T. \| last4 = Tani \| first4 = Y. \| last5 = Shichiri \| first5 = M. \| last6 = Sano \| first6 = T. \| last7 = Yamada \| first7 = S. \| last8 = Hirata \| first8 = Y. \| title = Differential expression of genes related to drug responsiveness between sparsely and densely granulated somatotroph adenomas. \| journal = Endocr J \| volume = 59 \| issue = 3 \| pages = 221-8 \| month = \| year = 2012 \| doi = \| PMID = 22200580 }}</ref>		*Sparsely granulated somatotroph adenomas are more invasive than other variants and respond less to medical treatment. <ref>{{Cite journal \| last1 = Kato \| first1 = M. \| last2 = Inoshita \| first2 = N. \| last3 = Sugiyama \| first3 = T. \| last4 = Tani \| first4 = Y. \| last5 = Shichiri \| first5 = M. \| last6 = Sano \| first6 = T. \| last7 = Yamada \| first7 = S. \| last8 = Hirata \| first8 = Y. \| title = Differential expression of genes related to drug responsiveness between sparsely and densely granulated somatotroph adenomas. \| journal = Endocr J \| volume = 59 \| issue = 3 \| pages = 221-8 \| month = \| year = 2012 \| doi = \| PMID = 22200580 }}</ref>
	* Lactotroph adenomas in men may show aggressive clinical behavior. <ref>{{Cite journal \| last1 = Delgrange \| first1 = E. \| last2 = Vasiljevic \| first2 = A. \| last3 = Wierinckx \| first3 = A. \| last4 = François \| first4 = P. \| last5 = Jouanneau \| first5 = E. \| last6 = Raverot \| first6 = G. \| last7 = Trouillas \| first7 = J. \| title = Expression of estrogen receptor alpha is associated with prolactin pituitary tumor prognosis and supports the sex-related difference in tumor growth. \| journal = Eur J Endocrinol \| volume = 172 \| issue = 6 \| pages = 791-801 \| month = Jun \| year = 2015 \| doi = 10.1530/EJE-14-0990 \| PMID = 25792376 }}</ref>		* Lactotroph adenomas in men may show aggressive clinical behavior. <ref>{{Cite journal \| last1 = Delgrange \| first1 = E. \| last2 = Vasiljevic \| first2 = A. \| last3 = Wierinckx \| first3 = A. \| last4 = François \| first4 = P. \| last5 = Jouanneau \| first5 = E. \| last6 = Raverot \| first6 = G. \| last7 = Trouillas \| first7 = J. \| title = Expression of estrogen receptor alpha is associated with prolactin pituitary tumor prognosis and supports the sex-related difference in tumor growth. \| journal = Eur J Endocrinol \| volume = 172 \| issue = 6 \| pages = 791-801 \| month = Jun \| year = 2015 \| doi = 10.1530/EJE-14-0990 \| PMID = 25792376 }}</ref>
	*~~Poorly differentiated~~ PIT-1 ~~positive adenomas~~ may show aggresive growth. <ref> {{Cite journal \| last1 = Mete \| first1 = O. \| last2 = Gomez-Hernandez \| first2 = K. \| last3 = Kucharczyk \| first3 = W. \| last4 = Ridout \| first4 = R. \| last5 = Zadeh \| first5 = G. \| last6 = Gentili \| first6 = F. \| last7 = Ezzat \| first7 = S. \| last8 = Asa \| first8 = SL. \| title = Silent subtype 3 pituitary adenomas are not always silent and represent poorly differentiated monomorphous plurihormonal Pit-1 lineage adenomas. \| journal = Mod Pathol \| volume = 29 \| issue = 2 \| pages = 131-42 \| month = Feb \| year = 2016 \| doi = 10.1038/modpathol.2015.151 \| PMID = 26743473 }}</ref>		*Immature PIT-1 lineage tumors may show aggresive growth. <ref> {{Cite journal \| last1 = Mete \| first1 = O. \| last2 = Gomez-Hernandez \| first2 = K. \| last3 = Kucharczyk \| first3 = W. \| last4 = Ridout \| first4 = R. \| last5 = Zadeh \| first5 = G. \| last6 = Gentili \| first6 = F. \| last7 = Ezzat \| first7 = S. \| last8 = Asa \| first8 = SL. \| title = Silent subtype 3 pituitary adenomas are not always silent and represent poorly differentiated monomorphous plurihormonal Pit-1 lineage adenomas. \| journal = Mod Pathol \| volume = 29 \| issue = 2 \| pages = 131-42 \| month = Feb \| year = 2016 \| doi = 10.1038/modpathol.2015.151 \| PMID = 26743473 }}</ref>

			===Molecular===
			*GNAS mutations frequently in densely granulated somatotroph tumors.

	==Pituitary blastoma==		==Pituitary blastoma==

Jensflorian: /* Microscopic */ TSH

2022-09-30T11:25:38Z

Microscopic: TSH

← Older revision		Revision as of 11:25, 30 September 2022
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	*Basophilic cells (corticotrophs).		*Basophilic cells (corticotrophs).
	*Eosinophilic cells(somatotrophs).		*Eosinophilic cells(somatotrophs).
			*Extensive fibrosis often seen in TSH-producing tumors.

	Notes:		Notes:
	*Smears very well.<ref>MUN. 24 November 2010.</ref>		*Smears very well.<ref>MUN. 24 November 2010.</ref>



	====Images====		====Images====

Jensflorian: /* Pituitary neuroendocrine tumor (PitNET) */ Update on PitNET

2022-09-30T10:58:05Z

Pituitary neuroendocrine tumor (PitNET): Update on PitNET

← Older revision		Revision as of 10:58, 30 September 2022
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	\| Gonadotroph tumor		\| Gonadotroph tumor
	\|		\|
	\| FSH, LH or a-Subunit or none		\| FSH, LH, a-Subunit or none
	\| SF1, ~~[[Estrogen receptor\|~~ER]], GATA3, CK+/-ve		\| SF1, ER, GATA3, CK+/-ve
	\|-		\|-
			\| None
			\| Plurihormonal tumor
	\|		\|
	\| ~~Null cell adenoma~~		\| All combinations possible
	\|		\| All combinations possible, CK+/-ve
			\|-
	\| None		\| None
			\| Null cell adenoma
			\|
			\| None (adenohypophyseal?)
	\| None		\| None
	\|}		\|}
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	Morphologic Classification:		Morphologic Classification:
	#~~Microadenoma~~ <= 1 cm.		#Microtumor <= 1 cm.
	#~~Macroadenoma~~ 1-4 cm.		#Macrotumor 1-4 cm.
	#Giant ~~adenoma~~ > 4cm.		#Giant tumor > 4cm.

	May be classified by what they secrete.		May be classified by what they secrete.

Jensflorian: /* Pituitary neuroendocrine tumor (PitNET) */ SF1 lineage

2022-09-30T10:53:40Z

Pituitary neuroendocrine tumor (PitNET): SF1 lineage

← Older revision		Revision as of 10:53, 30 September 2022
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	! PitNET type		! PitNET type
	! subtypes		! subtypes
	! Hormone ~~secretion~~		! Hormone IHC
	! Transcription factor		! Transcription factor IHC
	\|-		\|-
	\| PIT1		\| PIT1
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	\| TPIT		\| TPIT
	\|-		\|-
	\|		\| SF1
	\| Gonadotroph ~~adenoma~~		\| Gonadotroph tumor
	\| ~~Sparsely granulated adenoma~~		\|
	\| FSH, LH or a-Subunit		\| FSH, LH or a-Subunit or none
	\| SF1, [[Estrogen receptor\|ER]], ~~GATA2~~		\| SF1, [[Estrogen receptor\|ER]], GATA3, CK+/-ve
	\|-		\|-
	\|		\|

Jensflorian: /* Pituitary neuroendocrine tumor (PitNET) */ TPIT group

2022-09-30T10:52:10Z

Pituitary neuroendocrine tumor (PitNET): TPIT group

← Older revision		Revision as of 10:52, 30 September 2022
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	\|		\|
	\| PRL, GH (focal/variable), CK fibrous bodies		\| PRL, GH (focal/variable), CK fibrous bodies
	\| PIT1, [[Estrogen receptor\|ER]]		\| PIT1, [[Estrogen receptor\|ER]]
	\|-		\|-
	\|		\| PIT1
	\| Corticotroph ~~adenoma~~		\| Mixed somatotroph and lactotroph tumor
	\| Densely and sparsely granulated ~~adenoma~~, Crooke cell adenoma		\|
	\| ACTH,~~CAM 5.2~~		\| PRL, GH (in separate cells)
			\| PIT1, [[Estrogen receptor\|ER]] (only in lactotroph component)
			\|-
			\| TPIT
			\| Corticotroph tumor
			\| Densely and sparsely granulated tumors, Crooke cell adenoma
			\| ACTH,CK+ve
	\| TPIT		\| TPIT
	\|-		\|-

Jensflorian: /* DDx for sella turcica lesions */ PitNET is the new name!

2022-09-30T10:37:28Z

DDx for sella turcica lesions: PitNET is the new name!

← Older revision		Revision as of 10:37, 30 September 2022
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	=DDx for sella turcica lesions=		=DDx for sella turcica lesions=
	*[[Pituitary adenoma]].		*[[Pituitary adenoma\|PitNET]].
	*[[Rathke cleft cyst]].		*[[Rathke cleft cyst]].
	*[[Craniopharyngioma]].		*[[Craniopharyngioma]].

Jensflorian: /* Pituitary neuroendocrine tumor (PitNET) */ Update

2022-09-30T10:29:30Z

Pituitary neuroendocrine tumor (PitNET): Update

← Older revision		Revision as of 10:29, 30 September 2022
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	=Specific entities=		=Specific entities=
	==Pituitary neuroendocrine tumor (PitNET)==		==Pituitary neuroendocrine tumor (PitNET)==
	Old terminology '''Pituitary adenoma''' is depreceated		Old terminology '''Pituitary adenoma''' is depreceated.
			The WHO 2022 Classification of tumours of endocrine organs recoginizes following tumours:<ref>{{cite journal \|vauthors=Asa SL, Mete O, Perry A, Osamura RY \|title=Overview of the 2022 WHO Classification of Pituitary Tumors \|journal=Endocr Pathol \|volume=33 \|issue=1 \|pages=6–26 \|date=March 2022 \|pmid=35291028 \|doi=10.1007/s12022-022-09703-7 \|url=}}</ref>


			{\| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
			! PitNET lineage
			! PitNET type
			! subtypes
			! Hormone secretion
			! Transcription factor
			\|-
			\| PIT1
			\| Somatotroph tumor
			\| Densely and sparsely granulated tumor
			\| GH, a-subunit+/-, CK+
			\| PIT1
			\|-
			\| PIT1
			\| Lactotroph tumor
			\| Densely and sparsely granulated tumor
			\| PRL, CK-ve or weak
			\| PIT1, [[Estrogen receptor\|ER]]
			\|-
			\| PIT1
			\| Mammosomatotroph tumor
			\|
			\| GH, PRL (usu. less), CK perinuclear +ve
			\| PIT1, [[Estrogen receptor\|ER]]
			\|-
			\| PIT1
			\| Thyrotroph tumor
			\|
			\| TSH, CK-ve or weak
			\| PIT1, GATA3
			\|-
			\| PIT1
			\| Mature plurihormonal PIT1 lineage tumor
			\|
			\| GH, PRL, TSH, a-subunit +/-ve, CK perinuclear
			\| PIT1, [[Estrogen receptor\|ER]], GATA3
			\|-
			\| PIT1
			\| Immature PIT1 lineage tumor
			\|
			\| Only focal GH, PRL, TSH, a-subunit +/-ve, CK variable
			\| PIT1, [[Estrogen receptor\|ER]] +/-ve, GATA3 +/-ve
			\|-
			\| PIT1
			\| Acidophilic stem cell tumor
			\|
			\| PRL, GH (focal/variable), CK fibrous bodies
			\| PIT1, [[Estrogen receptor\|ER]]
			\|-
			\|
			\| Corticotroph adenoma
			\| Densely and sparsely granulated adenoma, Crooke cell adenoma
			\| ACTH,CAM 5.2
			\| TPIT
			\|-
			\|
			\| Gonadotroph adenoma
			\| Sparsely granulated adenoma
			\| FSH, LH or a-Subunit
			\| SF1, [[Estrogen receptor\|ER]], GATA2
			\|-
			\|
			\| Null cell adenoma
			\|
			\| None
			\| None
			\|}

			Other tumours may be classified as plurhormonal or double adenomas or as adenomas with unusual IHC combination.

	===General===		===General===
	*Clinical:<ref>{{Ref PBoD8\|1100}}</ref>		*Clinical:<ref>{{Ref PBoD8\|1100}}</ref>
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	*Smears very well.<ref>MUN. 24 November 2010.</ref>		*Smears very well.<ref>MUN. 24 November 2010.</ref>

	The WHO 2022 Classification of tumours of endocrine organs recoginizes following tumours:<ref>{{cite journal \|vauthors=Asa SL, Mete O, Perry A, Osamura RY \|title=Overview of the 2022 WHO Classification of Pituitary Tumors \|journal=Endocr Pathol \|volume=33 \|issue=1 \|pages=6–26 \|date=March 2022 \|pmid=35291028 \|doi=10.1007/s12022-022-09703-7 \|url=}}</ref>


	~~{\| class="wikitable sortable" style="margin-left:auto;margin-right:auto"~~
	~~! PitNET lineage~~
	~~! PitNET type~~
	~~! subtypes~~
	~~! Hormone secretion~~
	~~! Transcription factor~~
	\|-
	~~\| PIT1~~
	~~\| Somatotroph tumor~~
	~~\| Densely and sparsely granulated tumor~~
	~~\| GH, a-subunit+/-, CK+~~
	~~\| PIT1~~
	\|-
	~~\| PIT1~~
	~~\| Lactotroph tumor~~
	~~\| Densely and sparsely granulated tumor~~
	~~\| PRL, CK-ve or weak~~
	~~\| PIT1, [[Estrogen receptor\|ER]]~~
	\|-
	~~\| PIT1~~
	~~\| Mammosomatotroph tumor~~
	\|
	~~\| GH, PRL (usu. less), CK perinuclear +ve~~
	~~\| PIT1, [[Estrogen receptor\|ER]]~~
	\|-
	~~\| PIT1~~
	~~\| Thyrotroph tumor~~
	\|
	~~\| TSH, CK-ve or weak~~
	~~\| PIT1, GATA3~~
	\|-
	~~\| PIT1~~
	~~\| Mature plurihormonal PIT1 lineage tumor~~
	\|
	~~\| GH, PRL, TSH, a-subunit +/-ve~~
	~~\| PIT1, [[Estrogen receptor\|ER]], GATA3~~

	\|-
	\|
	~~\| Corticotroph adenoma~~
	~~\| Densely and sparsely granulated adenoma, Crooke cell adenoma~~
	~~\| ACTH,CAM 5.2~~
	~~\| TPIT~~
	\|-
	\|
	~~\| Gonadotroph adenoma~~
	~~\| Sparsely granulated adenoma~~
	~~\| FSH, LH or a-Subunit~~
	~~\| SF1, [[Estrogen receptor\|ER]], GATA2~~
	\|-
	\|
	~~\| Null cell adenoma~~
	\|
	~~\| None~~
	~~\| None~~
	\|}

	~~Other tumours may be classified as plurhormonal or double adenomas or as adenomas with unusual IHC combination.~~

Jensflorian: /* Pituitary neuroendocrine tumor (PitNET) */ PIT1 lineage update

2022-09-30T10:24:52Z

Pituitary neuroendocrine tumor (PitNET): PIT1 lineage update

← Older revision		Revision as of 10:24, 30 September 2022
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	! Transcription factor		! Transcription factor
	\|-		\|-
	\|
	~~\| Somatotroph adenoma~~
	~~\| Densely and sparsely granulated adenoma, Mammosomatotroph adenoma, Mixed GH and PRL adenoma~~
	~~\| GH +/- PRL~~
	\| PIT1		\| PIT1
			\| Somatotroph tumor
			\| Densely and sparsely granulated tumor
			\| GH, a-subunit+/-, CK+
			\| PIT1
			\|-
			\| PIT1
			\| Lactotroph tumor
			\| Densely and sparsely granulated tumor
			\| PRL, CK-ve or weak
			\| PIT1, [[Estrogen receptor\|ER]]
	\|-		\|-
	\|		\| PIT1
	\| ~~Lactotroph adenoma~~		\| Mammosomatotroph tumor
	\| ~~Densely and sparsely granulated adenoma, Acidophilic stem cell adenoma~~		\|
	\| PRL		\| GH, PRL (usu. less), CK perinuclear +ve
	\| PIT1, [[Estrogen receptor\|ER]]		\| PIT1, [[Estrogen receptor\|ER]]
	\|-		\|-
			\| PIT1
			\| Thyrotroph tumor
	\|		\|
	\| ~~Thyrotroph adenoma~~		\| TSH, CK-ve or weak
	\|		\| PIT1, GATA3
	\| TSH		\|-
	\| PIT1, [[Estrogen receptor\|ER]]		\| PIT1
			\| Mature plurihormonal PIT1 lineage tumor
			\|
			\| GH, PRL, TSH, a-subunit +/-ve
			\| PIT1, [[Estrogen receptor\|ER]], GATA3

	\|-		\|-
	\|		\|

Jensflorian: /* Pituitary adenoma */ Starting Update on 2022 WHO classification

2022-09-30T10:15:33Z

Pituitary adenoma: Starting Update on 2022 WHO classification

← Older revision		Revision as of 10:15, 30 September 2022
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	=Specific entities=		=Specific entities=
	==Pituitary ~~adenoma~~==		==Pituitary neuroendocrine tumor (PitNET)==
			Old terminology '''Pituitary adenoma''' is depreceated
	===General===		===General===
	*Clinical:<ref>{{Ref PBoD8\|1100}}</ref>		*Clinical:<ref>{{Ref PBoD8\|1100}}</ref>
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	**Tumor of adults.		**Tumor of adults.

	Classification:		Morphologic Classification:
	#Microadenoma <= 1 cm.		#Microadenoma <= 1 cm.
	#Macroadenoma 1-4 cm.		#Macroadenoma 1-4 cm.
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	*Smears very well.<ref>MUN. 24 November 2010.</ref>		*Smears very well.<ref>MUN. 24 November 2010.</ref>

	The WHO ~~2017~~ Classification of tumours of endocrine organs recoginizes following tumours:<ref>{{~~Cite~~ journal \| ~~last1~~ = ~~Lopes \| first1 = MBS.~~ \| title = ~~The 2017 World Health Organization classification~~ of ~~tumors~~ of ~~the pituitary gland: a summary.~~ \| journal = ~~Acta Neuropathol~~ \| volume = ~~134~~ \| issue = 4 \| pages = ~~521-535~~ \| ~~month~~ = ~~Oct~~ \| ~~year~~ = ~~2017~~ \| doi = 10.1007/~~s00401~~-~~017~~-~~1769~~-8 \| ~~PMID~~ = ~~28821944~~ }}</ref>		The WHO 2022 Classification of tumours of endocrine organs recoginizes following tumours:<ref>{{cite journal \|vauthors=Asa SL, Mete O, Perry A, Osamura RY \|title=Overview of the 2022 WHO Classification of Pituitary Tumors \|journal=Endocr Pathol \|volume=33 \|issue=1 \|pages=6–26 \|date=March 2022 \|pmid=35291028 \|doi=10.1007/s12022-022-09703-7 \|url=}}</ref>


	{\| class="wikitable sortable" style="margin-left:auto;margin-right:auto"		{\| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
	! ~~Adenoma~~ type		! PitNET lineage
			! PitNET type
	! subtypes		! subtypes
	! Hormone secretion		! Hormone secretion
	! Transcription factor		! Transcription factor
	\|-		\|-
			\|
	\| Somatotroph adenoma		\| Somatotroph adenoma
	\| Densely and sparsely granulated adenoma, Mammosomatotroph adenoma, Mixed GH and PRL adenoma		\| Densely and sparsely granulated adenoma, Mammosomatotroph adenoma, Mixed GH and PRL adenoma
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	\| PIT1		\| PIT1
	\|-		\|-
			\|
	\| Lactotroph adenoma		\| Lactotroph adenoma
	\| Densely and sparsely granulated adenoma, Acidophilic stem cell adenoma		\| Densely and sparsely granulated adenoma, Acidophilic stem cell adenoma
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	\| PIT1, [[Estrogen receptor\|ER]]		\| PIT1, [[Estrogen receptor\|ER]]
	\|-		\|-
			\|
	\| Thyrotroph adenoma		\| Thyrotroph adenoma
	\|		\|
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	\| PIT1, [[Estrogen receptor\|ER]]		\| PIT1, [[Estrogen receptor\|ER]]
	\|-		\|-
			\|
	\| Corticotroph adenoma		\| Corticotroph adenoma
	\| Densely and sparsely granulated adenoma, Crooke cell adenoma		\| Densely and sparsely granulated adenoma, Crooke cell adenoma
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	\| TPIT		\| TPIT
	\|-		\|-
			\|
	\| Gonadotroph adenoma		\| Gonadotroph adenoma
	\| Sparsely granulated adenoma		\| Sparsely granulated adenoma
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	\| SF1, [[Estrogen receptor\|ER]], GATA2		\| SF1, [[Estrogen receptor\|ER]], GATA2
	\|-		\|-
			\|
	\| Null cell adenoma		\| Null cell adenoma
	\|		\|