pituitary and adrenal pathology Flashcards
what does the anterior pituitary secrete
trophic and non trophic hormones
- TSH, ACTH, FSH, LH
- GH and prolactin
what does the posterior pituitary secrete
ADH and oxytocin
where is neurohypophysis found
posterior pituitary
where is the adenohypophysis found
anterior pituitary
what cells is the anterior pituitary composed of
- acidophils
- basophils
- chromophobe
what is the posterior pituitary composed of
non-myelinated axons of neurosecretory neurons
what can cause hyperfunction in anterior pituitary
- adenoma
- carcinoma
cause of anterior pituitary hypofunction
- surgery/radiation
- sudden haemorrhage
- ischaemic necrosis
- tumours
- inflammation
- hypothalamic lesions
- traumatic brain injury
cause of pituitary adenoma
sporadic or MEN1
effects of large pituitary adenomas
- visual field defects
- can cause pressure atrophy of surrounding normal tissue
- infarction can lead to panhypopituitarism
name three most commone functional pituitary adenomas
- prolactinoma
- growth hormone secreting
- ACTH secreting
symptoms of prolactinoma
- infertility
- lack of libido
- ammenorrhea
features of craniopharyngioma
- derived from remnants of Rathke’s pouch
- slow growing
- often cystic
- may calcify
- headaches and visual disturbances
what are the three zones of the adrenal cortex
- zona glomerulosa
- zona fasciculata
- zona reticularis
what is the medulla of the adrenal gland
central core of adrenal gland
what diseases can cause adrenal pathology
- pituitary disease
- ectopic ACTH secretion from other malignancies
- shock/DIC
causes of adrenal hypofunction
- hyperplasia
- adenoma
- carcinoma
what is congenital cause of adrenocorticol hyperplasia
- group of autosomal recessive disorders
- deficiency/lack of enzyme required for biosynthesis
- altered biosynthesis leads to increased androgen production
- reduced cortisol stimulates ACTH release and corticol hyperplasia
what is acquired cause of adrenocorticol hyperplasia
- endogenous ACTH production
- bilateral adrenal enlargement
- diffuse or nodular
- diffuse is ACTH driven
presentation of adrenocorticol tumours
- hormonal effects
- mass lesions
- carcinomas with necrosis can cause fever
histological features of adrenocorticol adenomas
- well differentiated
- small nuclei
- rare mitoses
- quite small
are adrenal carcinomas likely to be functional or non-functional
functional
spread of an adrenocorticol carcinoma
- local invasion (retroperitoneum, kidney)
- vascular
- peritoneum and pleura
- regional lymph nodes
features of adrenocorticol carcinoma
- large size
- haemorrhage and necrosis
- frequent mitoses
- lack of clear cells
- capsular or vascular invasion
cause of secondary adrenocorticol hypofunction
- failure to stimulate adrenal cortex
- suppression of adrenal cortex
treatment of adrenocorticol hypofunction if suppression of adrenal cortex
steroids
causes of chronic adrenocorticol insufficiency
- addison’s disease
- autoimmune adrenalitis
- infections
- metastatic malignancy
when does addison’s disease manifest
once significant decrease in glucocorticoid and mineralocorticoid levels
symptoms of addison’s disease
- weakness
- fatigue
- anorexia
- nausea
- vomiting
- weight loss
- diarrhoea
- pigmentation
who gets neuroblastomas
babies
what is phaechromocytoma derived from
chromaffin cells
symptoms of phaechromocytoma
-hypertension
complications of phaechromocytoma
cardiac failure
