Histopathology of growth hormone-secreting pituitary tumors: State of the art and new perspectives.

Autor: Guaraldi F; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Electronic address: federica.guaraldi@ausl.bologna.it., Ambrosi F; Pathology Unit, Maggiore Hospital-AUSL Bologna, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy. Electronic address: francesca.ambrosi3@unibo.it., Ricci C; Pathology Unit, Maggiore Hospital-AUSL Bologna, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy. Electronic address: costantino.ricci4@unibo.it., Di Sciascio L; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy. Electronic address: luisa.disciascio@studio.unibo.it., Asioli S; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy. Electronic address: sofia.asioli3@unibo.it.
Jazyk: angličtina
Zdroj: Best practice & research. Clinical endocrinology & metabolism [Best Pract Res Clin Endocrinol Metab] 2024 May; Vol. 38 (3), pp. 101894. Date of Electronic Publication: 2024 Apr 02.
DOI: 10.1016/j.beem.2024.101894
Abstrakt: Somatotroph (GH) adenomas/PitNETs typically arise from adenohypophysis and are biochemically active, leading to acromegaly and gigantism. More rarely, they present with ectopic origin and do not present overt biochemical or clinical features (silent variants). Histopathological examination should consider the clinical and radiological background, and include multiple steps assessing tumor morphology, pituitary transcription factors (PTFs), hormone secretion, proliferation markers, granulation, and somatostatin receptors (STRs), aimed at depicting as better as possible tumor origin (in case of non-functioning and/or metastatic tumor), and clinical behavior, including response to treatment. GH-secreting tumors are part of the Pit-1 family tumors and can secrete GH only (pure somatotrophs) or co-secrete prolactin (mixed tumors; in this case, various histological subtypes have been identified). Each subtype presents unique radiological, biochemical, and clinical characteristic. Therefore, the integration of biochemical, clinical, radiological, and histopathological elements is fundamental for proper diagnosis and management of pituitary adenomas/PitNETs, to be performed in referral Centers. In more recent times, the importance of genetic and epigenetic evaluation in the characterization of pituitary tumors (i.e., early identification of aggressive variants) has been outlined by some large studies, with the intention of improving targeted treatments.
Competing Interests: Declaration of Competing Interest The authors declare to have no conflict of interest.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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