Pituitary Pathology

Question 1

TTF1

Answer 1

Thyroid transcription factor - seen early in gestation in 3rd ventricle

Question 2

WHO grade for pituitary adenomas?

Answer 2

WHO Grade I - treated by surgical resection

Question 3

Differences between hyperfunctioning and non-functioning

Answer 3

Hyperfunctioning: excess hormone

Non-functioning: mass effect or visual disturbances

Question 4

What age group is affected by pituitary tumors?

Answer 4

Almost all affect middle age adults

Craniopharyngioma have 2 peaks:

• 5-15 yrs
• 45-60 yrs

Question 5

Someone comes in with bilateral temporal hemianopsia… what happened?

Answer 5

Pituitary adenoma that got bigger and compressed the optic chiasm

Question 6

Size does not equal aggressiveness, what does this mean?

Answer 6

Pituitary adenomas are WHO grade 1. They can be big, but surgically resected

Question 7

Can pit adenomas wander through brain?

Answer 7

No, but they do infiltrate cavernous sinuses

Question 8

Sporadic vs. familial adenomas

Answer 8

-

Question 9

Do neonates get pituitary masses?

Answer 9

Yes, germline mutation gives rise to pituitary blastoma (DICER1), almost always ACTH IHC (+)

Question 10

How can you see packaging granules of pituitary adenomas?

Answer 10

Synaptophysin stain - suitcase stain. You don’t know what is inside the suitcase, but you have something containing something

Question 11

Prolactinomas in premenopausal women and ACTH active adenomas are almost always ____? This means that ___ matters and it correlates with behavior.

Answer 11

Microadenomas

Subtyping matters.