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| Densely and sparsely granulated tumors, Crooke cell adenoma
| ACTH,CK+ve
| TPIT
|-
| SF1
| Gonadotroph tumor
|
| FSH, LH, a-Subunit or none
| SF1, ER, GATA3, CK+/-ve
|-
| None
| Plurihormonal tumor
|
| All combinations possible
| All combinations possible, CK+/-ve
|-
| None
| Null cell adenoma
|
| None (adenohypophyseal?)
| None
|}
Other tumours may be classified as plurhormonal or double adenomas or as adenomas with unusual IHC combination.
===General===
*Clinical:<ref>{{Ref PBoD8|1100}}</ref>
**Classically: visual field defects (bitemporal hemianopsia).
**Others (increased intracranial pressure): headache, nausea, vomiting.
**Tumor of adults.
Morphologic Classification:
#Microtumor <= 1 cm.
#Macrotumor 1-4 cm.
#Giant tumor > 4cm.
May be classified by what they secrete.
#Functional (endocrine hyperfunction).
#*Acromegaly/giantism.
#*Hyperprolactinemia.
#*Cushing disease.
#*Hyperthyroidism.
#*Significant elevation of FSH/LH.
#Clinically nonfunctioning.
Notes:
''Cushing disease'' is due to pituitary gland hypersecretion of ACTH (due to a pituitary adenoma ''or'' CRH hypersecretion from the hypothalamus).<ref name=Ref_PBoD8_1148>{{Ref PBoD8|1148}}</ref> [[Cushing syndrome]] is hypercortisolism ''not'' due to pituitary gland pathology.
Imaging:
*Sellar enlargement.
*Bone erosion, invasive growth esp. cavernous sinus (35-45%).
*Inhomogenous signal in T1w MRI.
====Familial pituitary adenomas====
A pituitary adenoma may be part of a familial syndrome:<ref name=pmid19564887>{{Cite journal | last1 = Elston | first1 = MS. | last2 = McDonald | first2 = KL. | last3 = Clifton-Bligh | first3 = RJ. | last4 = Robinson | first4 = BG. | title = Familial pituitary tumor syndromes. | journal = Nat Rev Endocrinol | volume =...
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
! Syndrome
! Gene
! Notes
|-
| [[Multiple endocrine neoplasia]] I
| MEN1
| characterized by the 3 Ps: '''p'''ituitary adenoma, [[parathyroid adenoma|'''p'''arathyroid adenoma]], [[pancreatic neuroendocrine tumour|'''p'''ancreatic neuroendocrine tumour]]
|-
| MEN-1-like syndrome
| CDKN1B<ref name=omim600778>{{OMIM|600778}}</ref>
| also known as ''Multiple endocrine neoplasia IV'' <ref name=omim600778>{{OMIM|600778}}</ref>
|-
| [[Carney syndrome]]
| PRKAR1A
| other findings (mnemonic ''NAME''): nevi, [[atrial myxoma]], myxoid neurofibroma, ephelides (freckles)
|-
| Isolated pituitary adenoma<ref name=pmid22612670>{{Cite journal | last1 = Korbonits | first1 = M. | last2 = Storr | first2 = H. | last3 = Kumar | first3 = AV. | title = Familial pituitary adenomas - Who should be tested for AIP mutations? | journal = Clin Endocrinol (Oxf) | volume = | issue = | pages = | month = ...
| AIP
| classically GH-producing adenoma - leads to acromegaly
|}
===Microscopic===
Features:<ref name=Ref_PSNP36>{{Ref PSNP|36}}</ref>
*Loss of fibrous stroma.
**The cells of a normal (anterior) pituitary are nested.
*Basophilic cells (corticotrophs).
*Eosinophilic cells(somatotrophs).
*Extensive fibrosis often seen in TSH-producing tumors.
Notes:
*Smears very well.<ref>MUN. 24 November 2010.</ref>
====Images====
<gallery>
Image:Nonfunctioning_pituitary_adenoma_%281%29.jpg | Pituitary adenoma - non-functioning. (WC/KGH)
File:HE fibrosis pituitary adenoma.jpg | Extensive interstitial and perivascular fibrosis in a pituitary adenoma (WC/jensflorian)
File:PRL HE histology.jpg | Pituitary adenoma - PRL producing, HE. Note the basophilic appearance of the cells (WC/jensflorian)
File:PRL adenoma treatment HE.jpg | Pituitary adenoma - PRL producing, HE. Extensive regressive changes after after dopamine agonist treatment (WC/jensflorian)
File:PRL IHC pituitary adenoma.jpg | Pituitary adenoma - PRL producing, Prolactin IHC (WC/jensflorian)
File:Densely granulated HGH producing adenoma.jpg | Pituitary adenoma - HGH producing, HE. The cells have a slightly eosinophilic appearance (WC/jensflorian)
File:Sparsely granulated HGH adenoma.jpg | Sparsely granulated adenoma - HGH producing. Note the numerous fibrous bodies in HE stain (WC/jensflorian)
File:HGH adenoma CK8.jpg | Sparsely granulated adenoma - HGH producing. CK8 IHC highlighting fibrous bodies (WC/jensflorian)
File:TSHoma HE.jpg | Pituitary adenoma - TSH producing. HE stain showing pleomorphism (WC/jensflorian)
File:TSHoma IHC-TSH.jpg | Pituitary adenoma - TSH producing. TSH IHC can be heterogeneous (WC/jensflorian)