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PubMedDate not supplied

[Pituitary neoplasms extending into the nasal cavity and their needle biopsy cytodiagnosis].

In 5.5% of 126 patients treated for hypophyseal tumors at the Burdenko Institute of Neurosurgery, AMS USSR for 12 months, spread of the new growth to the nasal cavity was revealed. The tumor was usually located in the posterosuperior parts of the nose and was discovered on anterior rhinoscopy only after the nasal mucosa had been carefully anemized, particularly with the use of a nasal dilator with a lamp on its end specially designed by us. Spread of a hypophyseal tumor to the nasal cavity was encountered when the tumor was very large and grew regularly in all directions or when it was marked by selective infrasellarg growth in the direction of the sphenoidal sinus. Cytologic examination of the punctate made it possible to determine the presence of the hypophyseal tumor and its character (benign, malignant) and differentiate it from other new growths and from c.s.p. cysts.

Adenocarcinoma↗
PubMed2006

Immunohistochemical expression of nestin in the non-tumorous hypophysis and in pituitary neoplasms.

The aim of the present work was to investigate whether nestin, a member of the intermediate filament family, is immunohistochemically expressed in the non-tumoral human hypophysis and pituitary neoplasms. Twenty-three normal pituitaries and 125 pituitary neoplasms were included. The tissues were formalin-fixed and paraffin embedded. The neoplasms were identified on hematoxylin-eosin stained sections and were classified by immunohistochemistry as well as electron microscopy. For immunohistochemistry, the streptavidin-biotin-peroxidase complex method was applied using appropriate controls. Several corticotrophs in the autopsy obtained pituitaries showed cytoplasmic nestin immunopositivity. No nestin immunoreactivity was found in other cell types in non-tumorous adenohypophyses and in the cells of various pituitary adenomas. Nestin was, however, expressed in a small proportion of endothelial cells in both anterior and posterior lobes. Staining was also noted in several pituicytes, neurohypophysial nerve fibers, and Herring bodies. In contrast to CD-34 and Factor-8 immunostaining which demonstrated immunopositivity in practically all endothelial cells of every capillary, nestin expression was only focally seen suggesting that the functional status of the immunoreactive and non-staining endothelial cells was not the same. No statistically significant correlation was apparent between nestin immunoreactivity and patient age, gender, tumor size, mitotic index, Ki-67, labeling nuclear index, hormonal immunoprofile, and tumor type. In conclusion, nestin expression in adenomas cannot be viewed as a biologically relevant marker of cell proliferation and as a prognostic indicator. The patchy expression of nestin in endothelial cells remains unexplained and its significance requires further studies.

Adenoma↗
PubMed2005

[Neuroendoscope-assisted endonasal-transsphenoidal surgery for pituitary neoplasms].

OBJECTIVE: To evaluate the effect of curative effect of endonasal transsphenoidal approach for removal of pituitary neoplasms (PNs) assisted by neuroendoscopy. METHODS: Seventy-eight consecutive PNs patients with sellar mass causing compression of optic nerve and optic chiasm shown by MRI or CT underwent tumor removal via the endonasal transsphenoidal approach with the help of neuroendoscope. RESULTS: Total removal of tumor in 71 cases (91.0%) and subtotal removal in 5 cases (6.4%) were achieved. Partial removal was carried out in the remaining 2 cases (2.6%) with fibrous tumor. There was no postoperative death. Follow-up with a median of 3 months in 67 patients revealed that preoperative diminished acuity caused by optic nerve compression was recovered in 64 cases (95.5%), and improved in 3 cases (4.5%). Among the 62 patients with preoperative visual field defects, postoperative recovery was achieved in 60 cases (96.8%), and improvement in 2 cases (3.2%). CONCLUSION: Endonasal transsphenoidal approach assisted by neuroendoscopy is an effective minimally invasive method for removing the PNs. Changing the angle of the endoscope intraoperatively helps removing the tumor safely and completely.

Adult↗
PubMed2006

Temozolomide therapy in a man with an aggressive prolactin-secreting pituitary neoplasm: Morphological findings.

Administration of temozolomide to a 46-year-old man with an invasive aggressive prolactin (PRL)-secreting pituitary neoplasm resulted in improvement of the clinical condition and significant decrease of blood PRL levels. Histologic, immunohistochemical, and electron microscopic study demonstrated marked morphological differences in the tumor exposed to temozolomide compared with the unexposed tumor. Necrosis, hemorrhagic areas, accumulation of connective tissue, focal inflammatory infiltration, and neuronal transformation were seen. Immunohistochemical prognostic indicators showed a reduction in growth potential. Based on the clinical, laboratory, and morphological findings, we recommend temozolomide therapy in patients with pituitary tumors not responding adequately to other treatment options.

Antineoplastic Agents, Alkylating↗
PubMed1977

[Functional histopathology of pituitary neoplasms (author's transl)].

The generally accepted classification of pituitary adenomas into eosinophilic, basophilic, mixed, and chromophobe types has not been very useful since no clear correlation exists between the staining character of the tumor cells and the clinical syndrome produced. The ultrastructural examination of different adenoma types with clinically manifest endocrine activity (acromegaly, amenorrhea-galactorrhea-syndrome, Cushing's disease) shows that the type of hormone secreted can only be determined in few cases. The ultrastructure is more representative of the activity of the secretory process than of the type of the product. Histoimmunological methods achieve the specific identification of the various types of adenomas with endocrine symptomatology. The so-called "chromophobe" adenomas, which only manifest signs of a space occupying lesion with pituitary insufficiency of varying degree and compression of the visual pathways, represent a mixed group. The majority of the cases (about 60%) shows increased prolactin secretion with amenorrhea or loss of potency, but without galactorrhea or gynecomastia. A small group of cases may either produce normal hormones (growth hormone or prolactin) at a very low rate, or secrete hormone fragments or abnormal, as yet undeterminable substances. The oncocytomas, which stain with eosin in light microscopy, seem to suffer from a defective metabolism and therefore may have lost the ability of hormone production.

Adenoma↗
PubMed2004

Xanthogranulomatous hypophysitis mimicking a pituitary neoplasm.

Hypophysitis is an inflammatory disease of the pituitary gland that clinically and radiologically mimics pituitary tumors. We report here a case of xanthogranulomatous hypophysitis mimicking a pituitary neoplasm.A 65-yr-old woman presented with weight loss, fatigue, and visual disturbance. Computed tomography demonstrated a round cystic low-density mass with calcification in the sella. A T1-weighted magnetic resonance imaging scan showed most of the mass as hyperintense. The capsule of the mass was strongly enhanced by gadolinium. Endocrinologic examination revealed hypocorticism and hypothyroidism. Diabetes insipidus (DI) developed after the administration of hydrocortisone. The patient also had hallucination and delusions of persecution. Transsphenoidal surgery was performed. Histologic examination of the removed tissue showed central necrosis surrounded by accumulation of foamy cells and epithelioid cells. Several multinucleated giant cells were also seen. The foamy cells and epithelioid cells were immunopositive for Kp-1, a marker of macrophages. The patient made an uneventful postoperative recovery. Although DI and hypofunction of adenohypophysis persisted, the visual disturbance and psychiatric disorder were resolved. We have described an unusual inflammatory lesion of the pituitary in the sellar region that was mimicking neoplasm. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.

Aged↗