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Head and Neck Pathology

, Volume 13, Issue 4, pp 677–680 | Cite as

Null Cell Adenoma of the Pituitary: Pseudo-rosettes Say It Best When Immunohistochemistry Says Nothing At All!

  • Vikram Singh
  • Kirti GuptaEmail author
  • Pravin Salunke
  • Sivashanmugam S. Dhandapani
Sine qua non Radiology-Pathology

Abstract

Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour. The histology was diagnostically challenging with notable presence of numerous perivascular pseudo-rosettes and negative immunoreactivity for all pituitary hormones. The differential diagnosis and importance of ancillary techniques is discussed.

Keywords

Null cell adenoma Pseudo-rosettes Sellar tumour Pituitary tumor 

Notes

Compliance with Ethical Standards

Conflict of interest

We do not have any financial disclosures and no conflicts of interests.

References

  1. 1.
    Lloyd RV, Osamura RY, Klöppel G, Rosai J, editors. WHO classification of tumours of endocrine organs. 4th ed. IARC: Lyon, 2017. pp. 34–38.Google Scholar
  2. 2.
    Nishioka H, Inoshita N, Mete O, Asa SL, Hayashi K, Takeshita A, Fukuhara N, Yamaguchi-Okada M, Takeuchi Y, Yamada S. The complementary role of transcription factors in the accurate diagnosis of clinically nonfunctioning pituitary adenomas. Endocr Pathol. 2015;26:349–55.CrossRefGoogle Scholar
  3. 3.
    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;35:57–61.CrossRefGoogle Scholar
  4. 4.
    Ramesh VG, Karthikeyan KV, Rajaraman S, Rao R. Pituitary ependymoma: report of a rare case with an insight into the histogenesis. Neurol India. 2013;61:545–6.CrossRefGoogle Scholar
  5. 5.
    Kontogeorgos G, Thodou E. The gonadotroph origin of null cell adenomas. Hormones (Athens) 2016;15:243–7.CrossRefGoogle Scholar
  6. 6.
    Kontogeorgos G, Kovacs K, Horvath E, Scheithauer BW. Null cell adenomas, oncocytomas, and gonadotroph adenomas of the human pituitary: an immunocytochemical and ultrastructural analysis of 300 cases. Endocr Pathol. 1993;4:20.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of HistopathologyPost Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  2. 2.Department of NeurosurgeryPost Graduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

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