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A standardised diagnostic approach to pituitary neuroendocrine tumours (PitNETs): a European Pituitary Pathology Group (EPPG) proposal

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Abstract

The 2017 World Health Organization (WHO) classification proposes to type and subtype primary adenohypophyseal tumours according to their cell lineages with the aim to establish more uniform tumour groups. The definition of atypical adenoma was removed in favour of high-risk adenoma, and the assessment of proliferative activity and invasion was recommended to diagnose aggressive tumours. Recently, the International Pituitary Pathology Club proposed to replace adenoma with the term of pituitary neuroendocrine tumour (PitNET) to better reflect the similarities between adenohypophyseal and neuroendocrine tumours of other organs. The European Pituitary Pathology Group (EPPG) endorses this terminology and develops practical recommendations for standardised reports of PitNETs that are addressed to histo- and neuropathologists. This brief report presents the results of EPPG’s consensus for the reporting of PitNETs and proposes a diagnostic algorithm.

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Acknowledgements

This multidisciplinary consensus was under the auspices of the annual EUROPIT course (European Multidisciplinary Course of Pituitary Tumours, Annecy, France), endorsed by ESE (European Society of Endocrinology).

Author information

Authors and Affiliations

  1. Department of Pathological Cytology and Anatomy, Foch Hospital, 40 rue Worth, 92151, Suresnes, France

    C. Villa

  2. INSERM U1016, CNRS UMR 8104, Cochin Institute, Paris Descartes University, 24 rue du faubourg Saint Jacques, 75014, Paris, France

    C. Villa

  3. Department of Endocrinology, CHU de Liège, University of Liège, Sart Tilman B35, 4000, Liège, Belgium

    C. Villa

  4. Université de Lyon 1, Université de Lyon, F-69000, Lyon, France

    A. Vasiljevic & J. Trouillas

  5. Faculté de Médecine Lyon-Est, F-69372, Lyon, France

    A. Vasiljevic & J. Trouillas

  6. Centre de Recherche en Cancérologie de Lyon (CRCL), INSERM U1052, CNRS UMR5286, Université de Lyon, Lyon, France

    A. Vasiljevic

  7. Centre de Pathologie et de Neuropathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France

    A. Vasiljevic

  8. Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy

    M. L. Jaffrain-Rea

  9. Neuromed Institute, IRCCS, Pozzilli, Italy

    M. L. Jaffrain-Rea

  10. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK

    O. Ansorge

  11. Department of Biomedical and Neuromuscular Sciences, Section of Anatomic Pathology ‘M. Malpighi’ at Bellaria Hospital, University of Bologna, Bologna, Italy

    S. Asioli

  12. Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy

    S. Asioli

  13. Department of Diagnostics and Public Health, University of Verona, Verona, Italy

    V. Barresi

  14. Department of Histology, Pharmacy, Sciences and Technology of Tirgu Mures, University of Medicine, Târgu Mureș, Romania

    L. Chinezu

  15. Department of Medicine DIMED, Surgical Pathology & Cytopathology Unit, University Hospital of Padova, Padova, Italy

    M. P. Gardiman

  16. Endocrinology Unit, Department of Biomedical Sciences, Humanitas University and Humanitas Research Hospital, Rozzano, Italy

    A. Lania

  17. Department of Fundamental Pathomorphology, Endocrine Research Center, Ministry of Health of Russia, Moscow, Russia

    A. M. Lapshina

  18. Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy

    L. Poliani

  19. 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary

    L. Reiniger

  20. Department of Pathology, Rizzoli Institute, Bologna, Italy

    A. Righi

  21. Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    W. Saeger

  22. The Fingerland Department of Pathology, University Hospital and Faculty of Medicine, Hradec Kralove, Charles University, Sokolska 581, 500 05, Hradec Kralove, Czech Republic

    J. Soukup

  23. Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany

    M. Theodoropoulou

  24. Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy

    S. Uccella

  25. Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

    F. Roncaroli

Authors
  1. C. Villa
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  2. A. Vasiljevic
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  3. M. L. Jaffrain-Rea
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  4. O. Ansorge
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  5. S. Asioli
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  6. V. Barresi
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  7. L. Chinezu
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  8. M. P. Gardiman
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  9. A. Lania
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  10. A. M. Lapshina
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  11. L. Poliani
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  12. L. Reiniger
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  13. A. Righi
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  14. W. Saeger
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  15. J. Soukup
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  16. M. Theodoropoulou
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  17. S. Uccella
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  18. J. Trouillas
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  19. F. Roncaroli
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Contributions

CV, AV, MLJ, JT and FR have conceived the study, designed the structure and written the manuscript. All the other authors have attended the EPPG meetings and have been involved in the correspondence to reach the final consensus on the recommendations proposed in the manuscript. Dr C. Casar-Borota and Dr E. Manojlovic Gacic, members of EPPG, declined to be co-authors of the present manuscript.

Corresponding author

Correspondence to C. Villa.

Ethics declarations

This manuscript aims at proposing a set of recommendation for safe reporting of pituitary neuroendocrine tumours. It does not involve any use of human or animal tissue. The manuscript has been written in accordance with the ethical framework of each University and in line with the regulations on authorships and plagiarism enacted in each Institution.

Conflict of interest

The authors declare that they have no conflict of interest.

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This article is part of the Topical Collection on Quality in Pathology

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Villa, C., Vasiljevic, A., Jaffrain-Rea, M.L. et al. A standardised diagnostic approach to pituitary neuroendocrine tumours (PitNETs): a European Pituitary Pathology Group (EPPG) proposal. Virchows Arch 475, 687–692 (2019). https://doi.org/10.1007/s00428-019-02655-0

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  • DOI: https://doi.org/10.1007/s00428-019-02655-0

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