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Review
. 2018 Apr;21(2):119-129.
doi: 10.1007/s11102-017-0855-1.

Histopathological classification of non-functioning pituitary neuroendocrine tumors

Emilija Manojlovic-Gacic  1 , Britt Edén Engström  2 , Olivera Casar-Borota  3   4
Affiliations
Review

Histopathological classification of non-functioning pituitary neuroendocrine tumors

Emilija Manojlovic-Gacic et al. Pituitary. 2018 Apr.

Abstract

Non-functioning pituitary neuroendocrine tumors do not cause endocrine symptoms related to hypersecretion of adenohypophyseal hormones and are clinically characterized by symptoms due to growing sellar tumor mass. Histopathological classification of this tumor group has always been challenging due to their heterogeneity, limited knowledge on their biology, and diverse methodological problems. We have searched PubMed database for data related to the histopathological classification of non-functioning pituitary tumors and methods for its application. Principles of the classification and grading presented in the recently released 4th edition of the World Health Organization classification of endocrine tumors have been summarized. Based on the expression of anterior pituitary hormones and pituitary specific transcription factors, gonadotroph tumors dominate within the group of clinically non-functioning tumors, followed by corticotroph type; however, other less common types of the non-functioning tumors can be identified. Assessment of tumor cell proliferation is important to identify "high-risk adenomas." A few subtypes of non-functioning tumors belong to the category of potentially aggressive tumors, independent of the cell proliferation rate. Here, we present up to date criteria for the classification of clinically non-functioning pituitary tumors, offer a diagnostic approach for the routine clinical use, and emphasize a need for inclusion of prognostic and predictive markers in the classification.

Keywords: Immunohistochemistry; Non-functioning pituitary neuroendocrine tumor; Pituitary adenoma; Transcription factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Importance of pituitary transcription factors in PitNETs with sparse or no hormone-immunolabeling: NF-gonadotroph tumor 1a hematoxylin eosin staining 1b negative immunolabeling for gonadotroph hormones (FSH and LH) 1c nuclear expression of SF-1; NF-corticotroph tumor 2a hematoxylin eosin staining 2b sparse ACTH expression 2c nuclear expression of T-Pit; NF-lactotroph tumor 3a hematoxylin eosin staining 3b sparse expression of prolactin 3c nuclear expression of Pit-1 (Magnification x400)
See this image and copyright information in PMC

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