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New WHO classification of pituitary adenomas (4th edition): assessment of pituitary transcription factors and the prognostic histological factors

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Abstract

WHO classification of pituitary adenomas was revised in 2017. The two major and significant changes are discussed. (1) The new classification focuses on adenohypophysial-cell lineage for the designation of adenomas, and thus, assessment of pituitary transcription factors is recommended. Its appropriate use has a complementary role in obtaining an accurate diagnosis, particularly in hormone-negative adenomas. Subclassification of nonfunctioning adenomas was revised accordingly and, consequently, null cell adenomas became quite rare. (2) “Atypical adenoma”, a previous category, was eliminated due to the poor reproducibility and predictive value. Assessment of tumor proliferation marker and other clinical parameters such as invasion are recommended to predict aggressiveness. “High-risk adenomas” are those with rapid growth, radiological invasion, and a high Ki-67 proliferation index, whereas some special adenoma subtypes commonly show aggressive behavior.

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Authors and Affiliations

  1. Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minatoku, Tokyo, 105-8470, Japan

    Hiroshi Nishioka

  2. Department of Pathology, Toranomon Hospital, Tokyo, Japan

    Naoko Inoshita

  3. Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Hiroshi Nishioka & Naoko Inoshita

Authors
  1. Hiroshi Nishioka
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  2. Naoko Inoshita
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Correspondence to Hiroshi Nishioka.

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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 35, 57–61 (2018). https://doi.org/10.1007/s10014-017-0307-7

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  • DOI: https://doi.org/10.1007/s10014-017-0307-7

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