Lecture 8 - Pathology of the Pituitary Flashcards
The pituitary gland is protected by a bony structure called the ____ _____, which is part of the _____ bone.
Sella Turcica
Sphenoid
Somatotrophs and Mammosomatotrophs are _______ (stain pink).
Lactotrophs are _______ (stain clear).
Corticotrophs and Thyrotrophs are _______ (stain blue/purple).
Acidophilic
Chromophobes
Basophilic
The most common cause of hyperpituitarism is an ______ arising in the _____ lobe. Most commonly, they secrete only 1 hormone, but they can secrete 2 or more. What is the most common combo of 2?
Keep in mind these tend to arise in patients aged ____-____.
Adenoma
Anterior
GH and PRL
35-60
The most common type of FUNCTIONING pituitary adenoma is the ________ adenoma.
Lactotroph
______ adenomas are the second most common pituitary adenomas. Diagnosis of pituitary GH excess requires elevated serum GH AND _____.
Cells producing GH will stain _______ (what color?) on immunohistochemistry.
Somatotroph
IGF-1
Brown
How is Cushing Disease different from Cushing Syndrome?
Disease –> pituitary adenoma (so high ACTH and Cortisol)
Syndrome –> adrenal adenoma (so low ACTH and HIGH Cortisol).
Nelson syndrome arises from development of a large, destructive pituitary adenoma after surgical removal of the _______ as treatment for Cushing syndrome.
Adrenals
Gain of function mutations in ______, which encodes the alpha subunit of Gs (G protein), leads to GH adenomas.
GNAS
Inactivating mutations in _______, a tumor suppressor gene, leads to Multiple Endocrine Neoplasia type 1 –> Pituitary adenomas (GH, PRL, and ACTCH varieties) are common in this disease.
MEN1
Microadenomas are considered < ____cm in size, while Macroadenomas are > _____cm in size.
1cm
1cm
______ is the term that describes sudden hemorrhage into the AP that presents with excruciating headache, diplopia, and hypopituitarism. It often leads to sudden death.
Apoplexy.
_______ syndrome occurs from postpartum necrosis of the pituitary. Why might this occur?
Look for postpartum mothers who are overly fatigued, can’t produce milk, or have severe headache.
Sheehan Syndrome
The pituitary almost doubles in size during pregnancy, but its blood supply remains the same. Thus, if the mother hemorrhages, the pituitary can become ischemic and necrotic.
Empty sella syndrome results from any pathology that destroys part or all of the pituitary, but it can also be mimicked in cases where the patient has increased ________ pressure (pressure displaces the pituitary.)
Intracranial pressure
Mutation of _____ can result in combined pituitary hormone deficiency (deficient GH, PRL, and TSH).
PIT-1
Syndrome of Inappropriate ADH (SIADH) results from excess ADH and can cause hyponatremia, _____ swelling, and neurological dysfunction. It is most commonly caused by malignancy (especially ____ ____ carcinoma of the lung), infections, and trauma.
Brain swelling
Small cell carcinoma
