Classification of Pituitary Tumors Table 112

The new World Health Organization classification divides pituitary tumors simplistically into

Table 11.2. Simplified classification of pituitary adenomas

GH cell adenoma

PRL cell adenoma

Mixed GH cell / PRL cell adenoma

Mammosomatotroph cell adenoma

ACTH cell adenoma

FSH/LH cell adenoma

TSH cell adenoma

Null cell adenoma

Pluri-hormonal adenoma

Unclassified adenoma pituitary adenomas and carcinomas, and the traditional categorization of pituitary adenomas by their tinctorial properties has been abandoned. Ultrastructural appearance, in particular the size of the cytoplasmic granules, also aids in the diagnosis of these tumors. The latter system, however, requires pituitary adenomas to be extensively examined by multiple modalities in specialist centers [2].

The majority of adrenocorticotrophic hormone (ACTH)-producing tumors are microscopic. GH, prolactin (PRL) and ACTH-containing tumors correlate well with endo-crinological behavior, whereas the others do not. Pituitary adenomas are also subdivided by virtue of their size into those less than 1 cm in diameter (microadenomas) and those greater than 1 cm (macroadenomas). These divisions usually correlate with presentation - microadenomas presenting with endocrinological manifestations and macroadenomas with compres-sive effects - although GH-secreting tumors and prolactinomas in males, in particular, may reach substantial size before diagnosis.

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