1. Pituitary gland
pathology

2. Clinical manifestations of pituitary disease
Hyperpituitarism

3. Hypopituitarism

4. Local mass effects

5. Most cases of hypofunction
arise from destructive processes directly involving
the anterior pituitary (although other mechanisms
have been identified).

6. -empty sella syndrome

7. Infarct of the pituitary

8. CONGENITAL
AND DEVELOPMENTAL
DISORDERS

9. Many transcription factors are implicated
in pituitary organogenesis,
and abnormalities of these factors may result
in congenital hypopituitarism.

10. Idiopathic GH deficiency

11. CYSTIC LESIONS

12. Rathke’s cleft cysts

13. Arachnoid cysts

14. Dermoid and epidermoid cysts

15. INFLAMMATORY DISORDERS

16. Lymphocytic hypophysitis

17. Granulomatous hypophysitis

18. Xanthomatous hypophysitis

19. Secondary hypophysitis
may be due to infectious agents
or may occur as part of a systemic process
such as sarcoidosis,
vasculitis
(Takayasu’s Disease,Wegener’s granulomatosis),
Crohn’s disease,
or Whipple’s disease.
It has been associated with ruptured
Rathke’s cleft cyst,
necrotizing adenoma,
and meningitis.

20. Infections associated
with AIDS
may also involve the pituitary.

21. PITUITARY HYPERPLASIA
may mimic adenoma.

22. Somatotroph hyperplasia.
Mammosomatotroph hyperplasia

23. Lactotroph hyperplasia
Corticotroph hyperplasia

24. Thyrotroph hyperplasia
Gonadotroph hyperplasia

25. Although hyperplasias may have similar
clinical presentations, a reticulin stain
can reliably distinguish adenohypophysial
hyperplasia from adenoma.

26. PRIMARY TUMOURS OF
ADENOHYPOPHYSEAL CELLS

27. The classification of pituitary adenomas
requires correlation between clinical manifestations
of hormone hypersecretion,
radiological determination of size and invasiveness,
and tumour morphology.
Tumour classification has been advanced
by the recognition of three main pathways
of adenohypophysial cytodifferentiation
based on expression of transcription factors
that regulate hormone genes.

28. The corticotroph pathway

29. Somatotrophs, lactotrophs,
mammosomatotrophs,
and thyrotrophs

30. Classification

31. ADENOMAS
ASSOCIATED WITH
GROWTH HORMONE EXCESS

32. Adenomas that produce GH excess with acromegaly or gigantism
represent up to 15% of pituitary adenomas.

33. ADENOMAS
ASSOCIATED WITH
PROLACTIN EXCESS

34. THYROTROPH ADENOMAS
ASSOCIATE WITH
TSH EXCESS

35. CORTICOTROPH ADENOMAS
ASSOCIATED WITH
ACTH EXCESS

36. GONADOTROPH ADENOMAS

37. CLINICALLY
NON-FUNCTIONING
PITUITARY ADENOMAS

38. PLURIHORMONAL
PITUITARY ADENOMAS

39. PITUITARY CARCINOMA

40. OTHER SUPRASELLAR TUMORS Neoplasms in this location may induce
hypofunction or hyperfunction of
the anterior pituitary, diabetes insipidus,
or combinations of these manifestations.

41. Craniopharyngioma
This benign, locally invasive tumour arises from remnants

42. Neuronal tumours, known as gangliocytomas
are composed of mature neurones that resemble
hypothalamic ganglion cells.

43. Gliomas of the sellar region

44. Meningiomas

45. Granular cell tumours
Chordomas
Schwannomas

46. UNUSUAL
PRIMARY TUMOURS

47. Germ cell tumours
Hematologic neoplasms

48. Mesenchymal tumours

49. METASTATIC
MALIGNANCIES