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Endocrine-Week 1/2 > Pituitary Pathology > Flashcards

Pituitary Pathology Flashcards

1
Q

The pathology of underlying hyperfunction is usually either ______ or ______

A

Hyperplasia (inc. number of secretory cells)

Neoplasm (Autonomous Secretory Cells)

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2
Q

The pathology of underlying hypofunction is usually either _____________ or _______________

A

Atrophy (dec. number of secretory cells)

Necrosis (ischemia, autoimmune destruction, etc.)

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3
Q

Due to large reserve capacity, hypofunction does not occur until roughly _________% of the gland tissue is gone

A

80-90

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4
Q

Adenomas are (benign/malignant) neoplastic transformations and are (more/less) common in Endocrine cancers

A

Benign; more

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5
Q

Adenocarcinomas are (benign/malignant) neoplastic transformations

A

Malignant

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6
Q

Endocrine neoplasias can be (functional/nonfunctional) where they produce tons of hormone

A

Functional

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7
Q

Endocrine neoplasias can be (functional/nonfunctional) where they are silent, but can have mass effect and impinge on neighbors

A

Nonfunctional

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8
Q

Histopathology of benign vs. malignant endocrine tumors is often similar, so diagnosis is usually based on…

A

Metastases (best)

Local Vascular/neural invasion

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9
Q

MEN

A

Multiple Endocrine Neoplasia

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10
Q

How might Autoantibodies affect endocrine function

A

Stimulate–> hyperfunction
Block–> hypofunction
WBC mediated destruction–> hypofunction

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11
Q

Special name for the Anterior Pituitary

A

Adenohypophysis (and Pars Distalis)

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12
Q

Special name for the Posterior Pituitary

A

Neurohypophysis (and Pars Nervosa)

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13
Q

The (Anterior/Posterior) Pituitary has tightly packed clusters of secretory cells with RICH vasculature; cells are named based on staining properties (acidophils, basophils, chromophobes) and secretory product (Lactotrophs, Thyrotrophs, etc.)

A

Anterior

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14
Q

The cells in the Anterior Pituitary are named by what conventions?

A 
Staining properties (Acidophils, Basophils, Chromophobes)
Secretory product (Lactotrophs, Thyrotrophs, etc.)
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15
Q

Which Pituitary secretory cells and its products are Acidophilic (2 total)

A

Somatotrophs –> GH

Lactotrophs –> Prolactin

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16
Q

Which Pituitary secretory cells and its products are Basophilic (4 total)

A

Thyrotrophs –> TSH
Corticotrophs –> ACTH
Gonadotrophs –> FSH & LH

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17
Q

The (Anterior/Posterior) Pituitary is composed of nervous tissue (axons and glial cells).

A

Posterior

18
Q

The cell bodies of the neurons in the Posterior Pituitary are located where?

A

Hypothalamus

19
Q

Mass effect is a consequence of….

A

space-occupying issue

20
Q

Pituitary adenomas arise from the (Anterior/Posterior) lobe

A

Anterior

21
Q

Pituitary neoplasm; usually arises from Anterior lobe; histologically has homogenous sheets of cells with LITTLE stroma; usually are monoclonal (involves inc. secretion of one hormone like Prolactin or ACTH)

A

Pituitary Adenoma

22
Q

Neoplasm; BENIGN and SLOW growing; usually either seen in CHILDREN or adults >65 yo; arises from remnant of Rathke’s pouch (so not from pituitary); usually SUPRAsellar; can be CYSTIC and calcified

A

Craniopharyngioma

23
Q

Histologic features of Craniopharyngioma

A

Cysts with Calcifications

24
Q

Vascular lesion of Pituitary; usually due to Postpartum Hypotension, DIC, Shock or Sickle Cell; most common form is “Sheehan Syndrome.”

A

Ischemic Necrosis

25
Q

Most common type of Pituitary Ischemic Necrosis; occurs postpartum; the majority of blood supply of anterior lobe is venous (low bp) –> anterior lobe enlarges during pregnancy –> uterine hemorrhage during delivery –> hypotension –> ischemia & necrosis

A

Sheehan Syndrome

26
Q

Pituitary Vascular lesion; SUDDEN expanding hemorrhage in adenoma leads to destruction of adjacent pituitary cells; hypopituitarism can clinically occur

A

Pituitary Apoplexy

27
Q

“to occur suddenly”

A

Apoplexy

28
Q

Lesion of the Pituitary due to the destruction of part or all of the Pituitary; due to surgery, radiation or congenital defect

A

Empty Sella Syndrome

29
Q

What can cause Empty Sella Syndrome

A

Surgery
Radiation
Congenital Defects (CSF has leaked into the sella turcica, putting pressure on the pituitary. This causes the gland to shrink or flatten)

30
Q

Most POSTERIOR Pituitary pathology is the result of…

A
  • Mass effect (impingement)

- Necrosis/destruction (infarcts, hemorrhage, surgery, etc.)

31
Q

a set of conditions characterized by autoimmune disease that causes multiple endocrine deficiencies, which affect the hormone-producing (endocrine) glands

A

Autoimmune Polyglandular Syndromes (APS)

  • Polyglandular endocrinopathies
32
Q

Pituitary gland is connected to hypothalamus by

A

infundibulum

33
Q

Pituitary enlargement can lead to impingement on pituitary itself. This can cause

A

panhypopituitarism

34
Q

Pituitary enlargement can lead to impingement on optic chiasm. This can cause

A

Bitemporal hemianopia

35
Q

Pituitary enlargement can lead to impingement on optic cavernous sinuses. This can cause

A

CN 3, 4, 5, 6 palsies

36
Q

Pituitary enlargement can lead to impingement on CSF. This can cause

A

headache due to increased pressure

37
Q

What size of pituitary neoplasms usually cause mass effects?

A

Macroadenoma (>= 1 cm)

*Microadenoma (<= 1 cm) usually cause no mass effects

38
Q

Diagnosis of pituitary neoplasms are made by

A

immunohistochemistry

39
Q

Empty sella syndrome and mass lesion (causing impingement of pituitary) usually involve both anterior and posterior lobes. Clinical presentation of this is

A

panhypopituitarism

40
Q

a condition in which the production and secretion of all hormones by the pituitary gland (both ant. and post.) is reduced

A

panhypopituitarism

41
Q

Clinical presentation of posterior pituitary lesions

A

Central diabetes insipidus (low/lack of ADH)

Endocrine-Week 1/2 (18 decks)

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