Difference between revisions of "Pituitary gland"

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m (autoimmune)
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==Anatomy and histology==
==Anatomy and histology==
===Anatomy===
Basic anatomy (simplified):<ref name=bowen>URL: [http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/histo_pit.html http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/histo_pit.html]. Accessed on: 31 October 2010.</ref>
Basic anatomy (simplified):<ref name=bowen>URL: [http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/histo_pit.html http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/histo_pit.html]. Accessed on: 31 October 2010.</ref>
*Anterior:
*Anterior:
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*Posterior - diencephalon (ventral aspect).
*Posterior - diencephalon (ventral aspect).


Image:
Images:
*[http://www.ouhsc.edu/histology/Glass%20slides/38_01.jpg Pituitary gland (ouhsc.edu)].
*[http://www.ouhsc.edu/histology/Glass%20slides/38_01.jpg Pituitary gland (ouhsc.edu)].
*[http://www.lab.anhb.uwa.edu.au/mb140/corepages/endocrines/Images/HypDevAni.gif Development of the pituitary - animation (anhb.uwa.edu)].


==Histology==
===Histology===
===Anterior===
====Anterior====
*Acidophils (40% of cells) = red or orange.
*Acidophils (40% of cells) = red or orange.
**GH, PRL.
**GH, PRL.
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*The cellular product (i.e. hormone produced) is not strictly correlated with the cell type.<ref name=Ref_PSNP26>{{Ref PSNP|26}}</ref>
*The cellular product (i.e. hormone produced) is not strictly correlated with the cell type.<ref name=Ref_PSNP26>{{Ref PSNP|26}}</ref>


===Posterior===
====Posterior====
Features:<ref name=Ref_PSNP26>{{Ref PSNP|26}}</ref>
Features:<ref name=Ref_PSNP26>{{Ref PSNP|26}}</ref>
*Herring bodies - '''key feature'''.
*Herring bodies - '''key feature'''.
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==External links==
==External links==
*[http://www.neuropathologyweb.org/ Neuropathology] - neuropathologyweb.org.
*[http://www.neuropathologyweb.org/ Neuropathology] - neuropathologyweb.org.
*[http://www.lab.anhb.uwa.edu.au/mb140/corepages/endocrines/endocrin.htm Endocrine histology (anhb.uwa.edu.au)].


[[Category:Neuropathology]]
[[Category:Neuropathology]]

Revision as of 13:31, 17 November 2010

The pituitary gland is known as the master gland.

Divisions:[1]

  • Anterior pituitary (AKA adenohypophysis).
  • Posterior pituitary (AKA neurohypophysis, neural pituitary).

Function

Anterior

Hormones:[2]

  • Growth hormone (GH).
  • Luteinizing hormone (LH)
  • Follicle-stimulating hormone (FSH)
  • Thyroid stimulating hormone (TSH)
  • Adrenocorticotropic hormone (ACTH)
  • Prolactin (PRL)

Mnemonic: "Go Look For The Adenoma Please" = GH, LH, FSH, TSH, ACTH, PRL.

Posterior

Hormones:[2]

  • Oxytocin.
  • Antidiuretic hormone (ADH).

Anatomy and histology

Anatomy

Basic anatomy (simplified):[3]

  • Anterior:
    • Pars distalis.
    • Pars intermedia.
  • Posterior:
    • Pars nervosa.

Embryological origin:[3]

  • Anterior - Rathke's pouch (roof of mouth).
  • Posterior - diencephalon (ventral aspect).

Images:

Histology

Anterior

  • Acidophils (40% of cells) = red or orange.
    • GH, PRL.
  • Basophils (10% of cells) = basophilic (light blue).
    • TSH, LH, FSH.
  • Chromophobes (50% of cells) = amphophilic (purplish/grey).

Notes:

  • The cellular product (i.e. hormone produced) is not strictly correlated with the cell type.[4]

Posterior

Features:[4]

  • Herring bodies - key feature.
    • Eosinophilic axonal dilations filled with lysosomes and neurosecretory granules.
  • Less cellular.
    • Usually more cellular in perivascular location.

Image: Herring bodies (ouhsc.edu).

DDx for stellar lesions

  • Pituitary adenoma.
  • Rathke cleft cyst.
  • Craniopharyngioma.
  • Germ cell tumour.
  • Meningioma.

Pituitary adenoma

General

  • Classically presents with visual field defects.

Microscopic

Features:[5]

  • Loss of fibrous stroma.

Rathke cleft cyst

See Head and neck pathology.
  • Arises from intermediate lobe.
  • Embryonic remnant.
  • Related to craniopharyngioma.

Craniopharyngioma

See Head and neck pathology.
  • Related to Rathke cleft cyst.

Necrosis

  • Rare.

Causes

  • Sheehan syndrome - secondary to blood loss in childbirth.[6]
  • Syphilis (fetal-maternal transmission).[7]
  • Mollaret's meningitis - very rare.[8] (???)
  • Spontaneous necrosis of pituitary tumours - case reports.[9]

Autoimmune hypophysitis

General

Features:[10]

  • Rare.
  • Autoantigens are unknown.
  • May be misdiagnosed as a nonsecreting adenoma.

Microscopic

Features:[10]

  • Lymphocytic infiltration.

See also

References

  1. ↑ http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/histo.html
  2. ↑ 2.0 2.1 http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/P/Pituitary.html
  3. ↑ 3.0 3.1 URL: http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/histo_pit.html. Accessed on: 31 October 2010.
  4. ↑ 4.0 4.1 Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 26. ISBN 978-0443069826.
  5. ↑ Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 36. ISBN 978-0443069826.
  6. ↑ URL: http://www.mayoclinic.com/health/sheehans-syndrome/DS00889. Accessed on: 16 November 2010.
  7. ↑ URL: http://pediatrics.aappublications.org/cgi/content/full/104/1/e4. Accessed on: 16 November 2010.
  8. ↑ Dancer CM, Woods ML, Henderson RD, Robertson T, Mungomery M, Allworth A (July 2008). "Mollaret's meningitis and pituitary failure associated with a Rathke's cleft cyst". Intern Med J 38 (7): 609–11. doi:10.1111/j.1445-5994.2008.01709.x. PMID 18715308.
  9. ↑ Sachdev Y, Evered DC, Hall R (April 1976). "Spontaneous pituitary necrosis". Br Med J 1 (6015): 942. PMC 1639254. PMID 1268492. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1639254/pdf/brmedj00512-0028a.pdf.
  10. ↑ 10.0 10.1 Tzou SC, Lupi I, Landek M, et al. (July 2008). "Autoimmune hypophysitis of SJL mice: clinical insights from a new animal model". Endocrinology 149 (7): 3461–9. doi:10.1210/en.2007-1692. PMC 2453094. PMID 18388197. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453094/.

External links

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