Advertisement

Virchows Archiv A

, Volume 394, Issue 3, pp 221–233 | Cite as

Heterogeneous pituitary adenomas

A light microscopic, immunohistochemical and electron microscopic study
  • D. Martinez
  • D. Barthe
Article

Summary

The combined use of several histological procedures (i.e. conventional light microscopy, immunohistochemistry and electron microscopy) among 45 unselected pituitary adenomas demonstrated the existence of 9 tumors (20%) containing several identifiable adenohypophy seal cell types. Thecellular associations were between 2 or 3 identifiable cell types. Mammosomatotrophic tumors were the most frequent but not the only mixed type (somatomammocorticotrophic, somatocorticotrophic tumors were also found). The cellular components varied in size but the cells appeared randomly distributed in the tumors. In all the adenomas there was an unidentified cell component (no reactivity with antisera used) varying from sparse to numerous elements. On adjacent sections the adenomatous cells reacted with a single specific antiserum, but in two cases the immunohistochemistry on contiguous paraffin embedded sections did not confirm this with certainty. These results confirm those of others and a new term is purposed to designate these tumors: heterogeneous pituitary adenomas. According to the nature and the proportions of the cell components the heterogeneous adenomas were subdivided into two groups: a group A which comprised adenomas formed by a major identifiable cellular type associated with one or two other less frequent cell types, and a group B formed by a predominant unidentifiable (no reactivity with immunochemical stainings) cell type associated with one or two other identified cell types. The present morphofunctional classifications of pituitary adenomas should be modified to include homogeneous adenomas with a single cell type and heterogeneous adenomas with several cell types.

Key words

Human pituitary adenoma Light and electron microscopy Immunohistochemistry Several adenohypophyseal cell types 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Brun JM, Bloch B, Bugnon C, Putelat R (1979) Grossesse gemellaire après bromocriptine chez une acromégale restée stérile après exérèse d'un adénome hypophysaire. Ann Endocrinol 40:551–552Google Scholar
  2. Corenblum B, Sirek AMT, Horvath E, Kovacs K, Ezrin C (1976) Human mixed somatotrophic and lactotrophic pituitary adenomas. J Clin Endocrinol Metab 42:857–863Google Scholar
  3. Cravioto H, Fukaya T, Zimmerman EA, Kleinberg DL, Flamm ES (1981) Immunohistochemical and electron-microscopic studies of functional and non functional pituitary adenomas including one TSH secreting tumor in a thyrotoxic patient. Acta Neuropathol (Berl) 53:281–292Google Scholar
  4. Cunningham GR, Huckins C (1977) An FSH and prolactin secreting pituitary tumor: pituitary dynamics and testicular histology. J Clin Endocrinol Metab 44:248–253Google Scholar
  5. Demura R, Kubo O, Demura H, Shizume K (1977) FSH and LH secreting pituitary adenoma. J Clin Endocrinol Metab 45:653–657Google Scholar
  6. Duello TM, Halmi NS (1977) Pituitary adenoma producing thyrotropin and prolactin. Virchows Arch [Pathol Anat] 376:255–265Google Scholar
  7. Duello TM, Halmi NS (1980) Immunocytochemistry of prolactin-producing human pituitary adenomas. Am J Anat 158:463–469Google Scholar
  8. Ezrin C, Horvath E, Kovacs E (1979) Anatomy and cytology of the normal and abnormal pituitary gland. In: De Groot LJ, Cahill JF, Odell W, Martini L, Potts JT, Nelson Don H, Steinberger E, Winegrad AI. (eds): Endocrinology Vol 1. Grune and Stratton, New York pp 103–121Google Scholar
  9. Favre L, Rogers LM, Cobb CA, Rabin D (1979) Gigantism associated with a pituitary tumor secreting growth hormone and prolactin and cured by transsphenoidal hypophysectomy. Acta Endocrinol 91:193–200Google Scholar
  10. Girod C, Dubois MP, Trouillas J (1976) Apport de l'immunofluorescence à l'étude cytologique des adénomas hypophysaires humains. Ann Endocrinol 37:279–280Google Scholar
  11. Girod C, Mazzuca M, Trouillas J, Tramu G, Lhéritier M, Beauvillain JC, Claustrat B, Dubois MP (1980) Light microscopy, fine structure and immunohistochemistry studies of 278 pituitary adenomes. In: Derome PJ, Jedynak CP, Peillon F (eds) II European Workshop on pituitary adenomas, Asclepios Publ Ed, Paris, pp 3–18Google Scholar
  12. Guyda H, Robert F, Colle E, Hardy J (1973) Histologic, ultrastructural and hormonal characterization of a pituitary tumor secreting both hGH and prolactin. J Clin Endocrinol Metab 36:531–547Google Scholar
  13. Halmi NS, Duello TM (1976) “acidophilic” pituitary tumors. Arch Pathol Lab Med 100:346–351Google Scholar
  14. Hardy J, Vezina JL (1976) Transsphenoidal neurosurgery of intracranial neoplasm. Adv Neurol 15:261–274Google Scholar
  15. Heitz PU (1979) Multihormonal pituitary adenomas. Horm Res 10:1–13Google Scholar
  16. Horn K, Erhardt F, Pickardt CR, Werder K, Scriba PC (1976) Recurent goiter, hyperthyroidism, galactorrhea due to a thyrotropin and prolactin producing pituitary tumor. J Clin Endocrinol Metab 43:137–143Google Scholar
  17. Horvath E, Kovacs K (1976) Ultrastructural classification of pituitary adenomas. Can J Neurol Sci 3:9–21Google Scholar
  18. Horvath E, Kovacs K, Singer W, Ezrin C, Kerenyi NA (1977) Acidophil stem cell adenoma of the human pituitary. Arch Pathol Lab Med 101:594–599Google Scholar
  19. Ilse G, Ryan N, Kovacs K, Ilse D (1980) Calcium deposition in human pituitary adenomas studied by histology, electron microscopy, electron diffraction and X ray spectrometry. Exp Pathol Bd 18, 377–376Google Scholar
  20. Kovacs K, Corenblum B, Sirek AM, Penz G, Ezrin C (1976) Localization of prolactin in chromophobe pituitary adenomas: study of human necropsy material by immunoperoxidase technique. J Clin Pathol 29:250–258Google Scholar
  21. Kovacs K, Horvath E, Ryan N, Ezrin C (1980) Null cell adenoma of the human pituitary. Virchows Arch [Pathol Anat] 387:165–174Google Scholar
  22. Landolt AM (1975) Ultrastructure of the human sella tumors. Acta Neurochir [Suppl] 22:1–167Google Scholar
  23. Landolt AM (1978) Praktische Bedeutung neuer Erkenntnisse über Struktur und Funktion von Hypophysenadenomen. Schweiz Med Wochenschr 108:1521–1535Google Scholar
  24. Linquette M, Herlant M, Fossati P, May JP, Decoulx M, Fourlinnie JC (1969) Adénome hypophysaire à cellules thyréotropes avec hyperthyroïdie. Ann Endocrinol 30:731–740Google Scholar
  25. Martinez AJ, Lee A, Moossy J, Maroon JC (1980) Pituitary adenomas: clinocopathological and immunohistochemical study. Ann Neurol 7:24–36Google Scholar
  26. Müller OA, Fink R, Werder KV, Scriba PC (1978) Hypersecretion of ACTH, growth hormone and prolactin in a patient with pituitary adenoma. Acta Endocrinol 87 (suppl 215): 4–5Google Scholar
  27. Peillon F, Vila-Porcile E, Olivier L, Racadot J (1970) L'action des oestrogènes sur les adénomes hypophysaires chez l'homme. Ann Endocrinol 31:259–270Google Scholar
  28. Pelletier G, Leclerc R, Labrie F (1976) Identification of gonadotropic cells in the human pituitary by immunoperoxydase technique. Mol Cell Endocrinol 6:123–138Google Scholar
  29. Pelletier G, Leclerc R, Labrie F, Cote J, Chretien M, Lis M (1977) Immunohistochemical localization of β lipotrophic hormone in the pituitary gland. Endocrinology 100:770–776Google Scholar
  30. Phifer R, Midgley AR, Spicer SS (1973) Immunohistologic and histologic evidence that folliclestimulating hormone and luteinizing hormone are present in the same cell type in the human pars distalis. J Clin Endocrinol Metab 36:125–141Google Scholar
  31. Roy S (1977) Ultrastructure of chromophobe adenoma of the human pituitary gland. J Pathol 122:219–223Google Scholar
  32. Saeger W (1977) Die Hypophysentumoren. In: Büngeler W, Eder M, Lennert K, Peters G, Sandritter W, Seifert G. (eds). Veröffentlichungen aus der Pathologie Vol 107. G Fischer, Stuttgart-New-York pp 1–240Google Scholar
  33. Scanarini M, Mingrino S (1979) Pituitary adenomas secreting more than two hormones. Acta Neuropathol 48:67–72Google Scholar
  34. Schechter J (1973) Electron microscopic studies of the human pituitary tumors. I-chromophobic adenomas. Am J Anat 158:371–386Google Scholar
  35. Shimizu T, Ishida Y, Takeda F (1978) Electron microscopy of the human pituitary adenomas. Correlation of the secretory granules with experimentally and clinically evaluated hormone synthesis function of the adenoma tissue. Neurol Med Chir 18:107–117Google Scholar
  36. Solcia E, Capella C, Buffa R, Frigerio B, Fontana P, Usellini L (1977) Tumori dell' adenoipofisi: diagnosi morfologica e classificazione. Pathologica 69:333–346Google Scholar
  37. Trouillas J, Girod C, Lhéritier M, Claustrat B, Dubois MP (1980) Morphological and biochemical relationships in 31 human pituitary adenomas with acromegaly. Virchows Arch [Pathol Anat] 389:127–142Google Scholar
  38. Ueda G, Moy P, Furth J (1973) Multihormonal activities of normal and neoplastic pituitary cells as indicated by immunohistochemical staining. Int J Cancer 12:100–114Google Scholar
  39. Zimmerman EA, Defendini R, Frantz AG (1974) Prolactin and growth hormone in patients with pituitary adenomas: a correlative study of hormone in tumor and plasma by immunoperoxydase technique and radioimmunoassay. J Clin Endocrinol Metab 38:577–585Google Scholar

Copyright information

© Springer-Verlag 1982

Authors and Affiliations

  • D. Martinez
    • 1
  • D. Barthe
    • 1
  1. 1.Laboratoire d'Histologie, Faculté de MédecineLimoges, CedexFrance

Personalised recommendations