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2009, Volume 25, Number 3, Page(s) 106-111
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DOI: 10.5146/tjpath.2009.01163 |
The Spectrum of Hormone Immunoreactivity in Typical and Atypical Pituitary Adenomas |
Yeşim ERTAN, Banu SARSIK, Taner AKALIN |
Ege Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, İZMİR, TÜRKİYE Department of Pathology, Ege University, Faculty of Medicine, IZMIR, TURKEY |
Keywords:
Pituitary adenoma, Atypical pituitary adenoma, Ki-67, p53 tumor supressor protein, Mitosis |
Objective: We aimed to assess the spectrum of hormone
immunoreactivity in our pituitary adenoma cases and discuss the
diagnostic parameters of atypical pituitary adenomas.
Material and Methods: A total of 166 pituitary adenoma cases
diagnosed from 2005 to 2008 in our department were included in the
present study. Hematoxylin-eosin stained and immunohistochemistry
performed slides (ACTH, PRL, GH, TSH, FSH, LH, Ki-67, and p53)
were evaluated. Cases having more than two mitoses on 10 high
power fields besides more than 3% Ki-67 index were accepted in the
atypical group.
Results: Histologically, 159 cases were typical pituitary adenoma
and 7 were atypical pituitary adenoma. Of the atypical pituitary
adenoma cases, one case was ACTH, one GH and one both GH and
prolactin hormone immunoreactive pituitary adenomas. Four cases
were hormone immunonegative adenomas. Of the typical pituitary
adenoma cases, 39 cases were GH, 19 ACTH, 17 prolactin, 10 FSH,
8 LH and one TSH immunreactive pituitary adenomas. Fourty-seven
cases were hormone immunonegative adenomas.Twenty-two of the
all pitutary adenoma cases had recurrence. Of these cases, 18 were
typical adenoma and four were atypical adenoma.
Conclusion: The ratio of prolactin immunoreactive pituitary adenoma
cases in the surgical material of neuropathology is decreasing due to
medical therapy. Atypical pituitary adenomas are not the sole factor
affecting the recurrence mechanism but these tumors have higher
recurrence rate compared with typical pituitary adenomas and we
think the proliferation index might be the principal approach in the
diagnosis of these lesions.
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