Pathology of the Pituitary and Adrenal Glands

Question 1

why does enlargement of the pituitary gland cause issues

Answer 1

it only has room to budge upwards (where the optic chasm is)

Question 2

what does the anterior pituitary do

Answer 2

secretes trophic and non-trophic hormones

Question 3

what are the trophic hormones

Answer 3

TSH, ACTH, FSH, LH

Question 4

what are the non-trophic hormones

Answer 4

GH and prolactin

Question 5

what does the posterior pituitary do

Answer 5

extension of the neural tissue

secretes ADH and oxytocin

Question 6

where is the anterior pituitary derived from

Answer 6

rathke’s pouch

Question 7

what cells are in the anterior pituitary

Answer 7

islands, cords of cells
acidophils
basophils
chromophobe

Question 8

what cells are in the posterior pituitary

Answer 8

non-myelinated axons of neurosecretory neurons

Question 9

what can cause hyper function of the anterior pituitary

Answer 9

adenoma

carcinoma

Question 10

what can cause hypo function of the anterior pituitary

Answer 10

surgery/radiation 
sudden haemorrhage 
ischaemic necrosis 
tumours 
inflam conditions (sarcoidosis)

Question 11

what diseases affects the posterior pituitary

Answer 11

Diabetes insidious

syndrome of innaporpriate ADH secretion (SIADH)

Question 12

what are pituitary adenomas

Answer 12

relatively common tumours derived from cells of the anterior pituitary

classified by cells time/hormone produces

Question 13

symptoms of large pituitary adenomas

Answer 13

visual field defects
can cause pressure atrophy of surrounding normal tissue
infection can lead to panhypopoituitarism

Question 14

what are some functional pituitary adenomas

Answer 14

porlactinoma
growth hormone secreting
ACTH secreting

Question 15

What causes pituitary hypo function

Answer 15

usually panhypopuitarism (rarely affects infividual hormones)

has many causes, pathological features depend on the cause

Question 16

what is craniopharyngioma

Answer 16

derived from remnants of rathke’s pouch

slow growing, often cystic, may calcify

most suprasella

causes headaches and visual disturbances

Question 17

what are some posterior pituitary syndromes

Answer 17

diabetes insipidus

SIADH secretion

Question 18

where are the adrenal glands located

Answer 18

superior and medial to the upper pole of the kidneys

composed of outer context and central medulla

Question 19

what causes hyper function of the adrenal glands

Answer 19

hyperplasia
adenoma
carcinoma

Question 20

what causes hypo function of the adrenal glands

Answer 20

acute
-waterhouse-friderchsen

chronic
-addisons disease

Question 21

what causes adrenocortical hyperplasia

Answer 21

can be congenital (autosomal recessive disorders) or acquired (endogenous ACTH production)

Question 22

who gets adrenocortical tumours

Answer 22

mainly adults
males and females equal
incidental finding

Question 23

characteristics of an adrenocortical adenoma

Answer 23

well circumscribed
encapsulated lesions
small (up to 2-3 cm)
composed of cells resembling adrenocortical cells
well differentiated, small nuclei, rare mitoses
can be functional but more likely not

Question 24

characteristics of adrenocortical carcinoma

Answer 24

rare
more likely to be functional, virilising tumours usually malignant
can closely resemble adenoma
spread of carcinoma

Question 25

what suggests that theres a carcinoma not an adenoma

Answer 25

large size 
haemorrhage and necrosis 
frequent mitosis. atypical mitoses 
lack of clear cells 
capsular or vascular invasion