Endocrine

Question 1

Pituitary granulomas

Answer 1

Sarcoidosis

Infection

Primary granulomatous hypophysitis

Question 2

Pituitary spindle cell lesions

Answer 2

Pituitary adenoma (esp thyrotropic)

Pituicytoma (gfap+)

Oncocytoma (ema, s100+)

Question 3

Suprasellar lesions

Answer 3

Germ cell tumour

Pilocytic astrocytoma

Question 4

Intrasellar lesions

Answer 4

CAMP GL(A)MP

Craniopharyngioma

Pituitary adenoma

Meningioma

Pituicytoma

Granular cell tumour

LCH

Mets

Plasmacytoma

Question 5

Sellar region cysts

Answer 5

Rathke cleft cyst (ck20+)

Craniopharyngioma

Dermoid/Epidermoid cyst (has keratin granules)

Question 6

Atypical pituitary adenoma (criteria)

Answer 6

Incr mitoses

Ki67>3%

P53+

Question 7

Pituitary carcinoma (criteria)

Answer 7

Craniospinal dissemination or systemic mets

Question 8

Abnormal parathyroid gland (definition)

Answer 8

>6mm

>60mg

no fat

Question 9

Parathyroid carcinoma (defining features)

Answer 9

documented metastases

local invasion

Question 10

Parathyroid carcinoma (secondary features) (8)

Answer 10

capsular invasion

vascular invasion

mitoses >5/10HPF

fibrous bands

tumour necrosis

sheet-like small cells

diffuse atypia

macronucleoli

Question 11

Parathyroid adenoma vs carcinoma (immunos)

Answer 11

carcinoma: parafibromin- PGP9.5+

Question 12

DDX Adrenal cortical ca

Answer 12

phaeochromocytoma

RCC

HCC

angiomyolipoma

liposarcoma

metastases

Question 13

modified Weiss criteria (adrenocortical carcinoma)

Answer 13

incr mitoses (2)

compact cells (2)

abnormal mitoses (1)

tumour necrosis (1)

invasion of capsule (1)

3 or more points: likely malignant

Question 14

PASS criteria (phaechromocytoma)

Answer 14

1 and 2 point features (mitoses, necrosis etc):

4 or more points = malignant potential

OR

metastases (= malignant)