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Zak, Endo/Repro 2 > Pituitary Pathology > Flashcards

Pituitary Pathology Flashcards

1
Q

What is the most common cause of hyperpituitarism?

A

Pituitary Adenomas

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2
Q

What is special about Atypical Adenomas?

A

They are more likely to be aggressive

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3
Q

Uniform, monomorphic sheets/cords of cells with an absence of reticulin

A

Pituitary Adenoma

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4
Q

What mutation is associated with Pituitary Adenomas?

A

GNAS –> inhibition of GPCR –> continual activation of hormone synthesis

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5
Q

Sx’s = amenorrhea, galactorrhea, loss of libido, infertility

A

Prolactinemia (commonly Lactotroph Adenoma)

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6
Q

What type of adenoma can cause gigantism and acromegaly?

A

Somatotroph Adenoma

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7
Q

What hepatic product is released due to a Somatotroph Adenoma?

A

IGF-1

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8
Q

What pituitary hormone is released due to a Somatotroph Adenoma?

A

GH

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9
Q

Sx’s = Increased body size with disproportionately long arms and legs, some signs of acromegaly in children

A

Gigantism

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10
Q

Sx’s = Enlarged jaw, feet, and hands, sausage-like fingers, thyroid, liver, heart, and adrenal issues

A

Acromegaly

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11
Q

What are some other findings due to GH oversecretion?

A

DM/Glucose intolerance
HTN
Muscle weakness
Gonadal dysfunction

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12
Q

How would you Dx a Somatotroph Adenoma?

A

Elevated serum GH/IGF-1 + failure to suppress GH after oral glucose load

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13
Q

What hormones does a Mammosomatotroph Adenoma secrete?

A

GH and PRL

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14
Q

What hormone does a Corticotroph Adenoma secrete and what is the net effect?

A

ACTH –> increased cortisol secretion –> hypercotisolism

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15
Q

What disease is due to excess ACTH secretion by a tumor?

A

Cushing Syndrome

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16
Q

What disease is due to excess ACTH secretion by the pituitary?

A

Cushing Disease

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17
Q

Corticotroph Adenomas will stain + for which things?

A

PAS, POMC

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18
Q

Sx’s = Buffalo hump, round face, stretch marks, ab weight gain, easy bruising, hirsutism

A

Excessive ACTH/Cortisol secretion

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19
Q

What is Nelson Syndrome?

A

Excessive cortisol secretion with no inhibitory effect due to Corticotroph Microadenoma present and surgical removal of the adrenal glands

20
Q

How does excess ACTH lead to hyperpigmentation?

A

ACTH is a precursor molecule for melanocytes

21
Q

What type of pituitary adenoma typically doesn’t cause any clinical Sx’s?

A

Gonadotroph Adenoma

22
Q

How doo Gonadotroph Adenomas typically cause Sx’s and what are those Sx’s?

A

Mass effect

Sx’s = impaired vision, HA, diplopia, pituitary apoplexy

23
Q

Define Plurihormonal Adenomas

A

They elaborate more than one hormone

Are aggressive

24
Q

How do non-functioning Pituitary Adenomas typically present?

A

Mass effect Sx’s

25
Q

How are Pituitary Carcinomas Dx?

A

By the presence of metastases

26
Q

What are the most common hormones secreted from Pituitary Carcinomas?

A

ACTH, PRL

27
Q

What is the most common cause of hypopituitarism?

A

Destruction of the anterior pituitary

28
Q

What is Sheehan syndrome?

A

Postpartum necrosis of the anterior pituitary

29
Q

What is the most common cause of ischemic necrosis of the anterior pituitary?

A

Sheehan syndrome

30
Q

What is Primary Empty Sella syndrome?

A

A defect in the diaphragma sella –> arachnoid mater/CSF herniating into sella –> expansion of sella –> compression of pituitary

31
Q

In what type of people does Primary Empty Sella syndrome typically occur?

A

Obese women with a history of multiple pregnancies

32
Q

What are the most common presenting Sx’s of Primary Empty Sella syndrome?

A

Visual field defects
Hyperprolactinemia
Other endocrine abnormalities

33
Q

Which hormone causes pallor due to loss of stimulatory effects on melanocytes?

A

MSH

34
Q

Decreased ADH secretion due to a pituitary issue…

A

Central DI

35
Q

Decreased ADH activity due to renal inability to find hormone…

A

Nephrogenic DI

36
Q

Sx’s = excessive urination with low specific gravity, increased serum Na/Osmolality, thirst and polydipsia, dehydration

A

DI

37
Q

Sx’s = hyponatremia, cerebral edema, neurologic dysfunction

A

SIADH

38
Q

What are the most common causes of SIADH?

A

ADH secreting neoplasm (small cell carcinoma of lung)
Drugs increasing ADH secretion
CNS disorders

39
Q

What tumors arise from remnants of the Rathke pouch?

A

Craniopharyngiomas

40
Q

What are the main presenting Sx’s of Craniopharyngiomas?

A

HA

Visual disturbances

41
Q

What is the morphology of Craniopharyngiomas?

A

Cystic and multilobulated with a capsule

42
Q

Morphology = Calcified, nests/cords of squamous epithelium with peripheral palisading and lamellar keratin

A

Adamantinomatous Craniopharyngioma

43
Q

Cysts containing cholesterol-rich, thick brown-yellow (machine-oil) fluid

A

Adamantinomatous Craniopharyngioma

44
Q

What age group do Adamantinomatous Craniopharygiomas affect?

A

Children

45
Q

Morphology = Solid sheets of papillae lined by well-differentiated squamous epithelium and NO calcifications, keratin, or cysts

A

Papillary Craniopharyngioma

46
Q

What age group do Papillary Craniopharyngiomas affect?

A

Adults

47
Q

What is the prognosis for Papillary Craniopharyngiomas?

A

Excellent, malignancy is very rare

Zak, Endo/Repro 2 (33 decks)

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