Pathology of Pituitary and Adrenal Glands Flashcards
What can go wrong with the pituitary gland?
Adenohypophysis - anterior
Neurohypophysis - posterior
Where is Adenohypophysis derived from?
Rathke’s pouch
What does the anterior produce?
TSH, ACTH, FSH, LH
GH and prolactin
What does the posterior produce?
ADH (vasopressin) and Oxytocin
Where does the pituitary sit?
Inferior to hypothalamus
Anterior to Pons
What makes up the Anterior P?
Islands, cords of cells
Acidophils: Somatotrophs and Mammotrophs
Basophils: Cortico, Thyro and Gonadotrophs
Chromophobe
What makes up the posterior?
Non-myelinated axons of neurosecretory neurons
What are hyperfunctions of the anterior?
Adenoma
Carcinoma
What are hypofunctions of the anterior?
Surgery/radiation Haemorrhage into gland Ischaemic necrosis Tumours extending into sella Inflam e.g. sarcoidosis
What 2 conditions effect the posterior?
Diabetes insipidus
SIADH
What symptoms can occur with an anterior adenoma?
Visual field defects
Atrophy of surrounding tissue
Infarction can lead to panhypopituitarism
What conditions can occur due to anterior adenomas?
Prolactinoma
Growth hormone secreting problems -gigantism or acromegaly
ACTH secreting problems - Cushings disease
What are reasons for pituitary hypofunction?
Traumatic brain injury Subarachnoid haemorrhage Surgery/radiation Granulomatous inflam - sarcoid, TB, meneingitis Infarction/Haemorrhage Hypothalmic lesions
Describe carniopharyngioma
Derived from rathke’s pouch
Describe the adrenal gland
Bilateral, 4-5 grams each
Sit superior and medial to upper pole of kindeys
Composed of outer cortext and a central medulla
What are the 3 areas of the central medulla of the kindey?
Zona Glomerulosa
Zona Fasciculata
Zona Reticularis
What is produced in the Zona Glomerulosa?
Mineralocoticoids
Aldesterone
What is produced in the Zone Fasciculata?
Glucocorticoids
Cortisol
What is produced in the Zona Reticularis?
Sex steroids
Glucocorticoids
Describe the adrenal gland medulla
Distinct from cortex
Innervated by pre-synaptic fibres from sympathetic nervous system
Neuroendocrine (Chromaffin) cells decrete catecholamines
What are adrenal hyperfunctions?
Hyperplasia
Adenoma
Carcinoma
What are adrenal hypofunctions?
Acute - waterhouse fridrichsen
Chronic - Addison’s disease
What systemic symptom can carcinomas with necrosis cause?
Fever
Describe an adrenalcorticol adenoma
Well circumscribed, encapsulated lesions
Usually small (2-3 cm)
Yellow/Yellow brown cut surface (lipid)
Composed of cells resembling adrenalcortical cells
