SFP: pituitary pathology I Flashcards
Where do ACTH-producing cells tend to be found in the pituitary?
Near the pars intermedia! Sometimes there is migration into the posterior pituitary, which is considered normal.
What happens to the anterior pituitary as we age?
Atrophy and fibrosis - this is normal!
What happens to the anterior pituitary during pregnancy?
It is hyperplastic! It’s working hard to create more hormone.
What is the stalk effect?
A slight elevation in prolactin. This can happen for non-pathologic reasons.
What is the most common pituitary tumor?
An adenoma.
What are clinical signs of a pituitary adenoma?
Headache, nausea, vomiting, visual field defects, specific hormone symptoms.
What kind of vision changes are associated with pituitary adenoma?
Loss of peripheral vision.
What gene can be associated with pituitary adenoma?
MEN I.
What is the general histology of adenomas?
Sheets of cells with small nuclei that may be basophilic or acidophilic; may also be loss of reticulin seen on stain.
What is pituitary apoplexy?
A pituitary adenoma becomes necrotic, causing an acute extreme headache.
What is the most common form of pituitary adenoma?
Prolactinoma.
What is prolactin secretion regulated by?
Dopamine.
What are symptoms of prolactinoma?
Menstrual irregularity, infertility, galactorrhea, impotence, visual field abnormality.
What are some non-tumor causes of prolactinemia?
Pregnancy, hypothyroidism, medication, ‘stalk effect’.
How do we do lab evaluation for hyperprolactinemia?
Fasting AM serum check.
How do we treat prolactinoma?
Dopamine agonists or surgery.
Describe GH producing adenomas.
2nd most common pituitary adenoma that may result in gigantism or acromegaly depending on if the growth plates have closed.
How do we evaluate GH excess?
Serum testing for IGF-1.
How can we treat GH producing adenomas?
Somatostatin analogues, GH receptor antagonists, surgery.
