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Anatomy of the Pituitary Gland

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Pituitary Adenomas

Abstract

This chapter details the normal anatomy and histology of the pituitary gland, as well as the pathology of the pituitary adenomas. Most pituitary adenomas are non-invasive, benign neoplams that occur frequently and grow slowly. They represent a heterogeneous group of tumors that can be characterized based on their functional activity and morphologic characteristics including histologic, immunohistochemical, transcription factors profiles, and ultrastructural features. The histopathologic descriptions presented here can be utilized to diagnose and classify the various pituitary tumor types currently defined by the World Health Organization (WHO).

The chapter has been endorsed by Prof. Emmanuel Jouanneau, , Service de Neurochirurgie, Hospices Civils de Lyon, Lyon, France

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References

  1. Campero A, Martins C, Yasuda A, Rhoton AL Jr. Microsurgical anatomy of the diaphragma sellae and its role in directing the pattern of growth of pituitary adenomas. Neurosurgery. 2008;62(3):717–23.; discussion -23. https://doi.org/10.1227/01.neu.0000317321.79106.37.

    Article  PubMed  Google Scholar 

  2. Yasuda A, Campero A, Martins C, Rhoton AL Jr, Ribas GC. The medial wall of the cavernous sinus: microsurgical anatomy. Neurosurgery. 2004;55(1):179–89.; discussion 89-90. https://doi.org/10.1227/01.neu.0000126953.59406.77.

    Article  PubMed  Google Scholar 

  3. Griessenauer CJ, Raborn J, Mortazavi MM, Tubbs RS, Cohen-Gadol AA. Relationship between the pituitary stalk angle in prefixed, normal, and postfixed optic chiasmata: an anatomic study with microsurgical application. Acta Neurochir. 2014;156(1):147–51. https://doi.org/10.1007/s00701-013-1944-1.

    Article  PubMed  Google Scholar 

  4. Cavallo LMSD, Villa A, Somma T, Cappabianca P. Anatomy of the sellar and parasellar region. In: Zada GM, Lopes MBS, Mukundan Jr S, Laws Jr ER, editors. Atlas of sellar and parasellar lesions. Switzerland: Springer International Publishing; 2016. p. 3–9.

    Chapter  Google Scholar 

  5. Bonneville JF. Normal pituitary gland and pregnancy. In: Bonneville JF, Bonneville F, Cattin F, Nagi S, editors. MRI of the pituitary gland. Switzerland: Springer International Publishing; 2016. p. 53–5.

    Chapter  Google Scholar 

  6. Melmed S. Pathogenesis of pituitary tumors. Nat Rev Endocrinol. 2011;7(5):257–66. https://doi.org/10.1038/nrendo.2011.40.

    Article  CAS  PubMed  Google Scholar 

  7. Melmed S. Pituitary-tumor endocrinopathies. N Engl J Med. 2020;382(10):937–50. https://doi.org/10.1056/NEJMra1810772.

    Article  CAS  PubMed  Google Scholar 

  8. Syro LV, Rotondo F, Moshkin O, Kovacs K. Nonpituitary sellar masses. In: Melmed S, editor. The pituitary. 4th ed. London: Academic Press; 2017. p. 631–41.

    Chapter  Google Scholar 

  9. Lopes SMB, Pernicone PJ, Scheithauer BW, Horvath E, Kovacs K. Pituitary and sellar region. In: Mills SE, editor. Histology for pathologists. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 343–72.

    Google Scholar 

  10. Le Tissier P, Fiordelisio Coll T, Mollard P. The processes of anterior pituitary hormone pulse generation. Endocrinology. 2018;159(10):3524–35. https://doi.org/10.1210/en.2018-00508.

    Article  CAS  PubMed  Google Scholar 

  11. Le Tissier P, Campos P, Lafont C, Romanò N, Hodson DJ, Mollard P. An updated view of hypothalamic-vascular-pituitary unit function and plasticity. Nat Rev Endocrinol. 2017;13(5):257–67. https://doi.org/10.1038/nrendo.2016.193.

    Article  CAS  PubMed  Google Scholar 

  12. Sav A, Rotondo F, Syro LV, Serna CA, Kovacs K. Pituitary pathology in traumatic brain injury: a review. Pituitary. 2019; https://doi.org/10.1007/s11102-019-00958-8.

  13. Parent AD, Perkins E. The hypothalamus. In: Haines DE, Mihailoff GA, editors. Fundamental neuroscience for basic and clinical applications. 5th ed. Elsevier; 2018. p. 442–57.

    Chapter  Google Scholar 

  14. Scully KM, Rosenfeld MG. Pituitary development: regulatory codes in mammalian organogenesis. Science. 2002;295(5563):2231–5. https://doi.org/10.1126/science.1062736.

    Article  CAS  PubMed  Google Scholar 

  15. Zhu X, Gleiberman AS, Rosenfeld MG. Molecular physiology of pituitary development: signaling and transcriptional networks. Physiol Rev. 2007;87(3):933–63. https://doi.org/10.1152/physrev.00006.2006.

    Article  CAS  PubMed  Google Scholar 

  16. Davis SW, Ellsworth BS, Peréz Millan MI, Gergics P, Schade V, Foyouzi N, et al. Pituitary gland development and disease: from stem cell to hormone production. Curr Top Dev Biol. 2013;106:1–47. https://doi.org/10.1016/b978-0-12-416021-7.00001-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Osamura RY, Lopes MBS, Grossman A, Kontogeorgos G, Trouillas J. Tumours of the pituitary gland. Introduction. In: Lloyd RV, Osamura RY, Klöppel G, Rosai J, editors. WHO classification of tumours of endocrine organs. 4th ed. Lyon: IARC press; 2017. p. 13.

    Google Scholar 

  18. Osamura RY, Grossman A, Korbonits M, Kovacs K, Lopes MBS, Matsuno A, Trouillas J. Pituitary adenoma. In: Lloyd RV, Osamura RY, Klöppel G, Rosai J, editors. WHO classification of tumours of endocrine organs. 4th ed. Lyon: IARC press; 2017. p. 14–8.

    Google Scholar 

  19. Syro LV, Rotondo F, Ramirez A, Di Ieva A, Sav MA, Restrepo LM, et al. Progress in the diagnosis and classification of pituitary adenomas. Front Endocrinol (Lausanne). 2015;6:97. https://doi.org/10.3389/fendo.2015.00097.

    Article  Google Scholar 

  20. Murray JF. LTP. Anterior pituitary: somatotrophs ( GH ) and lactotrophs (PRL). In: Litwack G, editor. Hormonal Signaling in biology and medicine: comprehensive modern endocrinology. London: Academic Press Elsevier; 2019. p. 171–201.

    Google Scholar 

  21. Heaney AP, Melmed S. Molecular targets in pituitary tumours. Nat Rev Cancer. 2004;4(4):285–95. https://doi.org/10.1038/nrc1320.

    Article  CAS  PubMed  Google Scholar 

  22. Vidal S, Horvath E, Kovacs K, Cohen SM, Lloyd RV, Scheithauer BW. Transdifferentiation of somatotrophs to thyrotrophs in the pituitary of patients with protracted primary hypothyroidism. Virchows Arch. 2000;436(1):43–51.

    Article  CAS  Google Scholar 

  23. Allaerts W, Vankelecom H. History and perspectives of pituitary folliculo-stellate cell research. Eur J Endocrinol. 2005;153(1):1–12. https://doi.org/10.1530/eje.1.01949.

    Article  CAS  PubMed  Google Scholar 

  24. Pires M, Tortosa F. Update on pituitary Folliculo-stellate cells. International archives of endocrinology. Clin Res. 2016;2 https://doi.org/10.23937/2572-407X.1510006.

  25. Nowell PC. The clonal evolution of tumor cell populations. Science. 1976;194(4260):23–8.

    Article  CAS  Google Scholar 

  26. Greaves M, Maley CC. Clonal evolution in cancer. Nature. 2012;481(7381):306–13. https://doi.org/10.1038/nature10762.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Merlo LM, Pepper JW, Reid BJ, Maley CC. Cancer as an evolutionary and ecological process. Nat Rev Cancer. 2006;6(12):924–35. https://doi.org/10.1038/nrc2013.

    Article  CAS  PubMed  Google Scholar 

  28. Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000;100(1):57–70.

    Article  CAS  Google Scholar 

  29. Almendro V, Marusyk A, Polyak K. Cellular heterogeneity and molecular evolution in cancer. Annu Rev Pathol. 2013;8:277–302. https://doi.org/10.1146/annurev-pathol-020712-163923.

    Article  CAS  PubMed  Google Scholar 

  30. Marusyk A, Polyak K. Tumor heterogeneity: causes and consequences. Biochim Biophys Acta. 2010;1805(1):105–17. https://doi.org/10.1016/j.bbcan.2009.11.002.

    Article  CAS  PubMed  Google Scholar 

  31. Caimari F, Korbonits M. Novel genetic causes of pituitary adenomas. Clin Cancer Res. 2016;22(20):5030–42. https://doi.org/10.1158/1078-0432.ccr-16-0452.

    Article  CAS  PubMed  Google Scholar 

  32. Syro LV, Rotondo F, Kovacs K, Korbonits M. Clinicopathologic features of familial pituitary adenomas. Diagn Histopathol. 2016;22(3):85–91. https://doi.org/10.1016/j.mpdhp.2016.02.004.

    Article  Google Scholar 

  33. Syro LV, Builes CE, Di Ieva A, Sav A, Rotondo F, Kovacs K. Improving differential diagnosis of pituitary adenomas. Expert Rev Endocrinol Metab. 2014;9(4):377–86. https://doi.org/10.1586/17446651.2014.922412.

    Article  CAS  PubMed  Google Scholar 

  34. Mete O, Lopes MB. Overview of the 2017 WHO classification of pituitary Tumors. Endocr Pathol. 2017; https://doi.org/10.1007/s12022-017-9498-z.

  35. Lopes MBS. The 2017 World Health Organization classification of tumors of the pituitary gland: a summary. Acta Neuropathol. 2017;134(4):521–35. https://doi.org/10.1007/s00401-017-1769-8.

    Article  CAS  PubMed  Google Scholar 

  36. Trouillas J, Roy P, Sturm N, Dantony E, Cortet-Rudelli C, Viennet G, et al. A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up. Acta Neuropathol. 2013;126(1):123–35. https://doi.org/10.1007/s00401-013-1084-y.

    Article  PubMed  Google Scholar 

  37. Asa SL, Casar-Borota O, Chanson P, Delgrange E, Earls P, Ezzat S, et al. From pituitary adenoma to pituitary neuroendocrine tumor (PitNET): an international pituitary pathology club proposal. Endocr Relat Cancer. 2017;24(4):C5–c8. https://doi.org/10.1530/erc-17-0004.

    Article  CAS  PubMed  Google Scholar 

  38. Syro LV, Rotondo F, Serna CA, Ortiz LD, Kovacs K. Pathology of GH-producing pituitary adenomas and GH cell hyperplasia of the pituitary. Pituitary. 2016:1–9. https://doi.org/10.1007/s11102-016-0748-8.

  39. Drummond J, Roncaroli F, Grossman AB, Korbonits M. Clinical and pathological aspects of silent pituitary adenomas. J Clin Endocrinol Metabol. 2018;104(7):2473–89. https://doi.org/10.1210/jc.2018-00688.

    Article  Google Scholar 

  40. Cooper O, Melmed S. Subclinical hyperfunctioning pituitary adenomas: the silent tumors. Best Pract Res Clin Endocrinol Metab. 2012;26(4):447–60. https://doi.org/10.1016/j.beem.2012.01.002.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Cuevas-Ramos D, Carmichael JD, Cooper O, Bonert VS, Gertych A, Mamelak AN, et al. A structural and functional acromegaly classification. J Clin Endocrinol Metab. 2015;100:122–31. https://doi.org/10.1210/jc.2014-2468.

    Article  CAS  PubMed  Google Scholar 

  42. Syro LVRF, Serna CA, Restrepo LM, Kovacs K. Overproduction of hormones by pituitary tumors. In: Litwack G, editor. Hormonal signaling in biology and medicine: comprehensive modern endocrinology. London: Academic Press Elsevier; 2019. p. 655–65.

    Google Scholar 

  43. Rotondo F, Kovacs K, Lloyd RV. The role of molecular pathology in the classification and clinicopathologic evaluation of pituitary neoplasms. Diagn Histopathol. 2018;24(3):95–103. https://doi.org/10.1016/j.mpdhp.2018.02.003.

    Article  Google Scholar 

  44. Kleinschmidt-DeMasters BK, Lopes MBS. Histologic features of pituitary adenomas and sellar region masses. In: Perry A, Brat DJ, editors. Practical surgical neuropathology: a diagnostic approach. 2nd ed. Elsevier; 2018. p. 453–91.

    Chapter  Google Scholar 

  45. Syro LV, Rotondo F, Cusimano MD, Di Ieva A, Horvath E, Restrepo LM, et al. Current status on histological classification in Cushing's disease. Pituitary. 2015;18(2):217–24. https://doi.org/10.1007/s11102-014-0619-0.

    Article  PubMed  Google Scholar 

  46. Di Ieva A, Davidson JM, Syro LV, Rotondo F, Montoya JF, Horvath E, et al. Crooke's cell Tumors of the pituitary. Neurosurgery. 2015; https://doi.org/10.1227/NEU.0000000000000657.

  47. Ben-Shlomo A, Cooper O. Silent corticotroph adenomas. Pituitary. 2018;21(2):183–93. https://doi.org/10.1007/s11102-018-0864-8.

    Article  CAS  PubMed  Google Scholar 

  48. Nishioka H, Inoshita N, Mete O, Asa SL, Hayashi K, Takeshita A, et al. The complementary role of transcription factors in the accurate diagnosis of clinically nonfunctioning pituitary adenomas. Endocr Pathol. 2015; https://doi.org/10.1007/s12022-015-9398-z.

  49. Nishioka H, Inoshita N. New WHO classification of pituitary adenomas (4th edition): assessment of pituitary transcription factors and the prognostic histological factors. Brain Tumor Pathol. 2018;35(2):57–61. https://doi.org/10.1007/s10014-017-0307-7.

    Article  PubMed  Google Scholar 

  50. Saeger W, Ludecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. Pathohistological classification of pituitary tumors: 10 years of experience with the German pituitary tumor registry. Eur J Endocrinol. 2007;156(2):203–16. https://doi.org/10.1530/eje.1.02326.

    Article  CAS  PubMed  Google Scholar 

  51. Raverot G, Burman P, McCormack A, Heaney A, Petersenn S, Popovic V, et al. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas. Eur J Endocrinol. 2018;178(1):G1–g24. https://doi.org/10.1530/eje-17-0796.

    Article  CAS  PubMed  Google Scholar 

  52. McCormack AI, Dekkers O, Petersenn S, Popovic V, Trouillas J, Raverot G, et al. Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016. Eur J Endocrinol. 2018; https://doi.org/10.1530/eje-17-0933.

  53. Di Ieva A, Rotondo F, Syro LV, Cusimano MD, Kovacs K. Aggressive pituitary adenomas—diagnosis and emerging treatments. Nat Rev Endocrinol. 2014;10(7):423–35. https://doi.org/10.1038/nrendo.2014.64.

    Article  CAS  PubMed  Google Scholar 

  54. Dai C, Sun B, Liu X, Bao X, Feng M, Yao Y, et al. O-6-Methylguanine-DNA methyltransferase expression is associated with pituitary adenoma tumor recurrence: a systematic meta-analysis. Oncotarget. 2017;8(12):19674–83. https://doi.org/10.18632/oncotarget.14936.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Micko ASG, Wohrer A, Hoftberger R, Vila G, Marosi C, Knosp E, et al. MGMT and MSH6 immunoexpression for functioning pituitary macroadenomas. Pituitary. 2017;20(6):643–53. https://doi.org/10.1007/s11102-017-0829-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Endocrinology, Clinica Medellin – Grupo Quirónsalud, Medellin, Colombia

    Nicolas Coronel-Restrepo

  2. Department of Neurosurgery, Hospital Pablo Tobon Uribe and Clinica Medellin – Grupo Quirónsalud, Medellin, Colombia

    Luis V. Syro

  3. Department of Laboratory Medicine, Division of Pathology and the Keenan Research Centre for Biomedical Science at the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    Fabio Rotondo & Kalman Kovacs

Authors
  1. Nicolas Coronel-Restrepo
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  2. Luis V. Syro
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  3. Fabio Rotondo
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  4. Kalman Kovacs
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Editor information

Editors and Affiliations

  1. Hermitage Medical Clinic, Dublin, Ireland

    Gianluca Tamagno

  2. Cell Biology, Physiology and Immunology, University of Córdoba, Cordoba, Spain

    Manuel D. Gahete

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Coronel-Restrepo, N., Syro, L.V., Rotondo, F., Kovacs, K. (2022). Anatomy of the Pituitary Gland. In: Tamagno, G., Gahete, M.D. (eds) Pituitary Adenomas. Springer, Cham. https://doi.org/10.1007/978-3-030-90475-3_1

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  • DOI: https://doi.org/10.1007/978-3-030-90475-3_1

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