J Korean Med Sci.  2014 Mar;29(3):405-410. 10.3346/jkms.2014.29.3.405.

Clinicopathologic Analysis of Pituitary Adenoma: A Single Institute Experience

• Cho HJ
• Kim H
• Kwak YJ
• Seo JW
• Paek SH
• Sohn CH
• Yun JM
• Kim DS
• Kang P
• Park P
• Park SH

• KMID: 1734929
• DOI: http://doi.org/10.3346/jkms.2014.29.3.405

Abstract

Pituitary adenoma (PA) is a common benign neuroendocrine tumor; however, the incidence and proportion of hormone-producing PAs in Korean patients remain unknown. Authors analyzed 506 surgically resected and pathologically proven pituitary lesions of the Seoul National University Hospital from 2006 to 2011. The lesions were categorized as: PAs (n = 422, 83.4%), Rathke's cleft cysts (RCCs) (n = 54, 10.6%), inflammatory lesions (n = 8, 1.6%), meningiomas (n = 4), craniopharyngiomas (n = 4), granular cell tumors (n = 1), metastatic renal cell carcinomas (n = 2), germinomas (n = 1), ependymomas (n = 1), and unsatisfactory specimens (n = 9, 1.8%). PAs were slightly more prevalent in women (M: F = 1:1.17) with a mean age of 48.8 yr (9-80 yr). Immunohistochemical analysis revealed that prolactin-producing PAs (16.6%) and growth hormone-producing adenomas (9.2%) were the most common functional PAs. Plurihormonal PAs and nonfunctioning (null cell) adenomas were found in 14.9% and 42.4% of patients with PAs, respectively. The recurrence rate of PAs was 11.1%, but nearly 0% for the remaining benign lesions such as RCCs. 25.4% of patients with PAs were treated by gamma-knife after surgery due to residual tumors or regrowth of residual tumor. In conclusion, the pituitary lesions and the proportions of hormone-producing PAs in Korean patients are similar to those of previous reports except nonfunctioning (null cell) PAs, which are unusually frequent.

Keyword

Pituitary Gland; Pituitary Neoplasms; Pituitary Adenoma; Clinicopathological Study; Pituitary Hormone

MeSH Terms

Adenoma/*pathology
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Central Nervous System Cysts/pathology
Child
Female
Growth Hormone/metabolism
Humans
Immunohistochemistry
Male
Middle Aged
Pituitary Neoplasms/*pathology
Prolactin/metabolism
Recurrence
Sex Factors
Young Adult
Growth Hormone
Prolactin

Figure

• 

  Fig. 1 Histopathological findings of PAs (H&E, ×200). (A) Sheet of monotonous cells with round nuclei and loss of normal lobular patterns in PA. (B) Rathke's cleft cyst lined by goblet cell-studded ciliated columnar epithelium, abutted by fibrocollagenous tissue with chronic inflammation. (C) Chronic hypophysitis with swollen anterior pituitary cells and massive lymphoplasma cell infiltration. (D) Sheet of eosinophilic cells with vesicular small round nuclei and abundant granular cytoplasm in granular cell tumor of the pituitary stalk.

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  Fig. 2 Gender and age distribution of patients with PA. PA was most common in patients in their 40s to 60s, with female predominance noted at these ages; male predominance was noted in patients < 20 yr and > 70 yr.

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  Fig. 3 Age distribution of patients with Rathke's cleft cyst (RCC) as compared with that of pituitary adenomas (PAs).

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