Cells of the adenohypophysis that include somatotrophs and lactotropes. Stain red.
Cells of the adenohypophysis that include gonadotropes, thyrotropes, and corticotropes. Strain purple/blue
Cells of the adenohypophysis that don't take up color. Possibly stem cells or possibly acidophils and basophils that have degranulated.
Most common cause of hyperpituitaris. Associated with MEN1. Soft, well-circumscribed tumor, confined to the sella turcica. May be invasive though.
May invade bone or cause compression of suprasellar things. DISRUPTED RETICULIN NETWORK. Sheets or cords of monomorphic cells.
↑mitoses, ↑ ki-67, p53
Can cause physiological hyperplasia of pituitary. But reticulin network is intact.
Most common pituitary adenoma. Serum hormone levels are often proportional to size of tumor.
Causes amenorrhea, galactorrhea, loss of libido, infertility. Acidophil and chromophobe cells. Undergoes dystrophic calcifications.
Most common bihormonal pituitary adenoma
Adenomas with IHC evidence of hormone production w/o any biochemical or clinical evidence
Treatment for prolactinomas
Constitutively inhibits prolactin secretion
Pituitary tumor that can cause gigantism (before closure of epiphyseal plate) or acromegaly.
Causes Organomegaly, diabetes mellitus, hypertension, gonadal dysfunction, GI cancers, heart failure, sleep apnea.
Diagnostic tests for Somatotroph (GH) Adenoma
Somatostatin analogs
Used to treat Somatotroph (GH) Adenoma.
GH receptor antagonists
Used to treat Somatotroph (GH) Adenoma.
The typical syndrome (truncal obesity, buffalo hump, moon-like face, easy bruising, striae) associated with hypercortisolism.
Undectable serum ACTH, no cortisol suppression by dexamethasone suppression test and serum cortisol.
When the source of hypercortisolism is a pituitary adenoma
Normal or increased ACTH. Low dose of Dexamethasone test will not suppress, but high dose will.
Excessive and usually out-of-control growth of a corticotroph microadenoma after bilateral adrenalectomy.
Associated with hyperpigmentation (increased MSH from POMC). No hypercortisolism (no adrenal glands).
Usually microadenomas with basophilic cells. Causes Cushing disease.
In patients with glucocorticoid excess, normal corticotrophs develop accumulations of intermediate filaments composed of keratin that have a glassy appearance on histology.
Secretion by non-pituitary tumors
Very high serum ACTH. No cortical suppression with Dexamethason test and serum cortizol.
Hypopituitarism with evidence of posterior pituitary dysfunction (in the form of diabetes insipidus)
All pituitary hormones are deficient, and sexual development is impaired.
Chief endocrine form of dwarfism and may be hereditary; tumors, infections, or infarction (tissue death) of the pituitary. In many cases, other endocrine and sexual functions
remain normal
Derived from remnants of Rathke pouch. Benign, slow-growing, cystic.
Thick brownish yellow fluid. Bimodal age distribution;childhood (5-15 yrs), adults (65 yrs). The typical presentation is a cystic suprasellar mass with calcifications in a child or teenager. Two types adamantinomatous or papillary.
Groups of squamous cells with picket fence-like arrangement at the periphery (palisading), line up a large cyst filled with what is called wet keratin due to its waxy quality, hemo
Most common type.
Craniopharyngioma with less wet keratin. Periphery is darker, middle is spongy. No reticulous pattern.
Less common type.
Epithelium-lined benign cystic dilatation of Rathke pouch remnants in the intermediate lobe of pituitary. Common in adults.
Histology: Ciliated cuboidal or columnar epithelium with occasional goblet cells and areas of squamous metaplasia.
Sudden hemorrhage into a pituitary adenoma; in to macroadenomas and those that rapidly grow.
Sudden onset of excruciating headache. Diplopia due to pressure on CN III. Hypopituitarism. In severe cases, cardiovascular collapse, LOC and sudden death. This is a neurosurgical emergency!
Hyperplasia of ant. pituitary without increased blood supply during pregnancy.
Obstetrics hemorrhage and shock precipitates further reduction in blood supply to pituitary leading to infarction. Panhypopituitarism. Initial symptom is absence of lactation.
Rare autoimmune disease of anterior pituitary. Common postpartum. Autoantibodies against anterior pituitary cells
Mass effect and hypopituitarism. Lympho-plasmacytic infiltration of pituitary tissue
Any condition that destroys part or all of pituitary gland.
Diplopia, bitemporal hemianopia, Internal carotid A occlusion (stroke), Destruction of adjacent bone, Increased intracranial pressure (headache, nausea, vomiting).
Autosomal dominant. Pituitary tumors, parathyroid adenomas, and pancreas adenomas.
Lack of ADH being secreted from posterior pituitary.
Polyuria, urine with low specific gravity, hypernatremia, ↑ thirst, polydipsia, dehydration
Lack of activation of ADH receptor in nephron
Polyuria, urine with low specific gravity, hypernatremia, ↑ thirst, polydipsia, dehydration
The hyponatremia and hypo-osmolality resulting from inappropriate, continued secretion or action of the antidiuretic hormone despite normal or increased plasma volume, which
results in impaired water excretion. Cerebral edema, neurologic dysfunction. No peripheral edema! Caused by small cell carcinoma of lung, drugs, or CNS disorders.
The feared complication of excessive, overly rapid correction of hyponatremia.
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