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Pathology of prolactinomas: any predictive value?

Abstract

Lactotroph adenomas, also called prolactinomas and prolactin-secreting adenomas, constitute nearly 80% of functioning pituitary tumors and about 30–50% of all adenomas in the clinical practice. Lactotroph adenomas occur in the general population at a prevalence of 45/100,000, are more common in women, but also involve men and children of both sexes. Most lactotroph adenomas are microadenomas occurring in reproductive-age women who present with oligo/amenorrhea, galactorrhea, and infertility. In men and elderly women, lactotroph adenomas are usually macroadenomas and are most commonly associated with symptoms of a tumoral mass, including headaches, neurologic defects, and visual loss. Although clinical and laboratory features may differ depending on patient’s gender and age, the histopathology of the tumors is similar. Lactotroph adenomas are histologically classified into three subtypes: the common sparsely granulated lactotroph adenoma, and the rare densely granulated lactotroph adenoma and acidophilic stem cell adenoma. We will review the main pathological features of the lactotroph adenomas and some of their characteristics that may predict biological behavior and responsiveness to treatment.

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Acknowledgements

The author is thankful to Dr. Mary Lee Vance, Professor of Medicine at the Division of Endocrinology & Metabolism, University of Virginia, for her insightful review of the manuscript.

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Correspondence to M. Beatriz S. Lopes.

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Lopes, M.B.S. Pathology of prolactinomas: any predictive value?. Pituitary 23, 3–8 (2020) doi:10.1007/s11102-019-00997-1

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Keywords

  • Pituitary neoplasm
  • Prolactinoma
  • Lactotroph adenoma
  • Prl-secreting adenoma