|Clinicopathological characterization of TSH-producing adenomas: special reference to TSH-immunoreactive but clinically non-functioning adenomas.|
|PMID: 19774499 Owner: NLM Status: MEDLINE|
|Thyrotropin (thyroid-stimulating hormone (TSH))-producing pituitary adenomas have been known to be quite variable in clinical features covering from typical functioning TSH-producing adenomas (FTSHomas) associated with hyperthyroidism to clinically silent TSH cell adenomas (STAs) that are apparently unassociated with hyperthyroidism. It is important to distinguish STAs from other types of clinically non-functioning adenomas for adequate postoperative managements. However, because of rareness of TSH-producing adenomas, their histopathological features linking to the clinical manifestations have not been well characterized. Herein, we investigated clinical and histopathological findings to characterize 29 TSH-producing adenomas including 20 FTSHomas and nine STAs. Clinical symptoms of the patients with STAs included headache, visual defect, vertigo, and nausea. All STAs and 19 FTSHomas were macroadenoma. The average tumor size of STAs was significantly larger than that of FTSHomas (P < 0.05). The invasiveness was detected in 33% STAs and in 20% FTSHomas. Both STAs and FTSHomas showed a variety of morphological features and immunohistochemical profiles. Chromophobic polygonal or short-spindled tumor cells usually proliferated in a diffuse pattern, while they exhibited globoid or whorl-like appearance with intertwined cytoplasmic processes in both subgroups. Stromal fibrosis and calcification were often noted. Their nuclei were somehow pleomorphic. Ultrastructural features of all four STAs examined were similar to those of normal thyrotrophs. Thus, STAs and FTSHomas were indistinguishable by histology alone. Immunohistochemically, the number of TSH-positive cells in individual FTSHomas was highly various. Six tumors showed only a few TSH-positive cells (1-5%), and three were negative for TSH by conventional method without antigen retrieval. After proteinase K treatment, these tumors turned out TSH positive. As defined, STAs were TSH positive in more than 20% of tumor cells and three of them in more than 50%. Growth hormone- and/or prolactin-positive cells were detected in 55% STAs and 63% FTSHomas. Both pituitary-specific transcription factor 1 and GATA-binding protein 2 were expressed in all STAs and 20 FTSHomas. Membranous somatostatin receptor (SSTR)-2A immunoreactivity was found in 89% STAs and 94% FTSHomas, whereas SSTR5 was positive in 78% of both STAs and FTSHomas. MIB-1 labeling index was related to tumor invasiveness and tumor size (P < 0.05, P = 0.09, respectively). Thus, although both STAs and FTSHomas showed unique histopathological features distinct from other type adenomas, these two subgroups were indistinguishable by histopathology. Immunohistochemistry for TSH by use of antigen retrieval, transcription factors, and SSTRs may be useful to confirm STAs and to determine the postoperative therapy among various kinds of clinically non-functioning adenomas.|
|Elaine Lu Wang; Zhi Rong Qian; Shozo Yamada; Md Mustafizur Rahman; Naoko Inosita; Teruyoshi Kageji; Hideko Endo; Eiji Kudo; Toshiaki Sano|
Related Documents :
|1649119 - Changes in hormone production of a recurrent silent corticotroph adenoma of the pituita...
9024719 - Pituitary carcinoma: a clinicopathologic study of 15 cases.
16311409 - Genetics and proteomics of pituitary tumors.
19020999 - Runx1 and runx2 upregulate galectin-3 expression in human pituitary tumors.
18946739 - Pituitary gland and beta-catenin signaling: from ontogeny to oncogenesis.
11761429 - Classification of pituitary adenomas.
12052339 - Effect of tumor infiltrating lymphocytes on the expression of mhc molecules in canine t...
6840489 - Case report: fourteen-year follow-up of an apudoma of the bile ducts at the hilum of th...
3263079 - Comparison of growth inhibition of a human ovarian adenocarcinoma cell line by free mon...
|Type: Journal Article|
|Title: Endocrine pathology Volume: 20 ISSN: 1559-0097 ISO Abbreviation: Endocr. Pathol. Publication Date: 2009|
|Created Date: 2010-01-21 Completed Date: 2010-03-18 Revised Date: -|
Medline Journal Info:
|Nlm Unique ID: 9009288 Medline TA: Endocr Pathol Country: United States|
|Languages: eng Pagination: 209-20 Citation Subset: IM|
|Department of Human Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, Tokushima 770-8503, Japan.|
|APA/MLA Format Download EndNote Download BibTex|
GATA2 Transcription Factor / analysis, genetics
Microscopy, Electron, Scanning
Neoplasm Recurrence, Local
Pituitary Neoplasms / chemistry, pathology*, surgery
RNA, Messenger / analysis
Receptors, Somatostatin / analysis
Reverse Transcriptase Polymerase Chain Reaction
Thyrotropin / analysis*, biosynthesis*
Transcription Factor Pit-1 / analysis, genetics
|0/GATA2 Transcription Factor; 0/RNA, Messenger; 0/Receptors, Somatostatin; 0/Transcription Factor Pit-1; 0/somatostatin receptor 2; 0/somatostatin receptor 5; 9002-71-5/Thyrotropin|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Polyneuropathy Associated with Cholesterol Crystal Embolism.
Next Document: Interaction between fatness and fitness on CVD risk factors in Asian youth.