EPIDEMIOLOGY, CLASSIFICATION AND DIAGNOSIS OF FUNCTIONING AND NONFUNCTIONING PITUITARY ADENOMAS
DOI:
https://doi.org/10.56782/pps.114Keywords:
pituitary adenomas, proliferative index, electron microscopyAbstract
Pituitary adenomas are the most common intracranial tumors and usually are regarded as benign. According to the 2004 WHO classification, tumors of the anterior pituitary are divided into adenomas, atypical adenomas and cancers. Atypical pituitary adenomas are defined as pituitary adenomas with an elevated proliferative index (>3%). They are clinically classified mainly on the basis of their size, radiological features and hormonal secretion. Patients present with symptoms of, among others, hyperthyroidism, Cushing's disease, and hyperprolactinemia. The lack of correlation between clinical and pathological characteristics of these tumors limits the usefulness of routine histological diagnosis. To facilitate their correct diagnosis, the World Health Organization (WHO, 2004) recommends tests based on immunohistochemical methods, which have become the „gold standard” of modern diagnostics. This method is useful in the evaluation of both hormonally functional and nonfunctional adenomas. Especially for the diagnosis of clinically nonfunctional adenomas, immunohistochemistry makes it possible to demonstrate the presence of hormone in examined tumor sections. EM methods are capable of providing specific diagnosis in the majority of the rare adenoma subtypes with specific biological behavior, invasiveness, aggressive growth potential and recurrences.
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