Pathology Hypothalamus & Pituitary

Pathology Hypothalamus & Pituitary

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Local mass effects Visual abnormalities, bitemporal hemianopsia, elevated intracranial pressure and pituitary apoplexy
Invasive adenomas 30% of cases, the adenomas are not encapsultaed and infiltrate neighbouring tissues.
Haemmorhage and necrosis are more common in smaller adenomas False, larger adenomas.
Pituitary adenomas ar more common in adults True, 30-60 years of age is the peak incidence.
Microscopic features of a pituitary adenoma -Sheets or cords of of uniform polygonal cells-Supporting connective tissue is sparse-Nuclei: Uniform or pleomorphic
Densely granulated GH adenomas -Composed of monomorphic acidophillic cells-Strong cytoplasmic GH reactivity
Sparsely granulated GH adenoma -Composed of chromophobe cells
bihormonal mammosomatotroph -Express both GH and prolactin
Other GH adenoma disturbances Gonadal dysfunction, diabetes melitus, generalized muscle weakness, hypertension, arthritis, CHF, and increased risk of GI cancers.
Hypercortisolism Cushing's Syndrome
Nelson Syndrome Large destructive adenomas can develop after the removal of the ADRENAL GLANDS FOR TREATMENT OF CUSHINGS SYNDROME. -loss of inhibitory effect of adrenal corticosteroids on a pre-existing corticotroph microadenoma.
Hypopituitarism -Occurs when approx. 75% of the parenchyma is lost or absent-
SIADH Syndrome of innappropriate ADH secretion
SIADH causes -Malignant ectopic neoplasms(SCCs of the lung)-drugs-CNS disorders-infections and trauma
Most common suprasellar lesions Gliomas and craniopharyngiomas
Cliniacal manifestations of SIADH Hyponatraemia, cerebral oedema and resultant neurologic dysfunction
Craniopharyngioma -derived from rathkes pouch-bimodal age distribution-headach and visual disturbance-children might present with GH defeciency
two distinct histological variants of craniopharyngiomas -Adamantinous (most observed in kids)-Papillary(most observed in adults)

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