Pituitary+parathyroid Flashcards Preview

Endocrine > Pituitary+parathyroid > Flashcards

Flashcards in Pituitary+parathyroid Deck (33):
1

parathyroid hyperplasia morphology

typically multigland, affecting all glands

loss of normal adipocytes, though some fat remains

ssimilar to adenomas, but no rim of normal gland

2

second most common pituitary tumor

 

presentation

Growth hormone cell adenoma

gigantism or acromegaly

4

Asrenocortical adenoma morphology

small, encapsulated, unilateral

predominantly fasiculata cells

most are non functional

alveolar architecture and lipid rich cells

4

parathyroid adenoma morphology

typically solitary, unilateral mass

primarily chief cells with islands of oxyphil cells

loss of normal adipocytes within tumor

typically rim of compressed normal parathyroid at periphery

5

Adrenal cortex morphology - zona fasciculata

clear cells

6

Pheochromocytoma =

neoplasms of adrenal medulla chromafin cells

synthesize and secrete catecholamines > HTN

7

pituitary adenoma morpholohy

uniform cells in sheets or cords

supporting reticulin network is lost

7

Li-fraumeni syndrome =

inherted cause of

inherited cause of adrenocortical carcinoma

mutant p53 alelle

(also breast CA, sarcoma, leukemia, brain CA)

8

causes of hypopituitarism

Pituitary tumors - mass effect

Pituitary adenoma

Cranipharyngioma

Sheenhan Syndrome

Iatrogenic (surgery or radiation)

Rathke Cleft Cyst 

8

Sheehan syndrome

pospartum necrosis caused by ischemia or pituitary gland

8

adrenal medulla morphology

chromaffin cells with rich vascular network

9

Conn Syndrome = 

hyperaldosteronism caused by adrenal cortical adenoma

10

most common finding in endogenous cushings

bilateral hyperplasia

11

causes of hypercortisolism (and mechanism)

Cortical atrophy - exogenous gluccocorticoid (dec ACTH)

Bilateral hyperplasia - endogenous hypercortisolism, ZF hyperplasia (inc ACTH)

 

Adrenocortical adenoma - endogenous secretion of cortisol (ACTH independent)

Adrenocortical carcinoma - (ACTH independent)

13

Beckwith-Wiedmann syndrome = 

 

genetic cause of ___

genetic cause of Adrenocortical carcinoma

genomic imprinting of ch11 at WT2 locus

enlargement of body organs or body segments

(also Wilm's tumor, hepatoblastoma, rhabdomyosarcoma, pancreatic tumors)

13

relative distribution of primary hyperparathyroidism

Parathyroid adenoma

hyperplasia

carcinoma

80% adenoma

15% hyperplasia

5% carcinoma

14

Craniopharyngioma morphology

bening suprasellar or sellar tumors arising from Rathke Pouch

nests and cords of squamous columnar cells in loose stroma, often cystic an associated with calcification

14

parathyroid carcinoma morphology

firm lesion

adheres to surrounding tissue (infiltration)

very high calcium

dx based on invasion or metatasis

16

Rule of 10s for Pheochromocytoma

10% familial (MEN-2A, MEN-2B, type 1 neurofibromatosis, on Hippel Lindau, Sturge Weber)

10% extra adrenal = paragangliomas

10% bilateral

10% malignant - more frequent in extra-adrenal

17

large pituitary tumors can cause

bilatemporal hemianopsia

18

pituitary adenomas are classified based on 

immunohistochemistry stains regardless of fxnl stus

19

pheochromocytoma morphology

small nests of zellnallen chromafin cells with rich vascular network

cytoplasm typically granular and basophilic

pleomorphic nuclei

20

adrenocortical hyperplasia morphology

bilateral thickening of adrenal cortex

predominantly fasciculata cells

diffuse with relatively even thickening

OR

nodular with multiple bilateral nodules separated by thickened cortex

Fat

22

aside from prolactin cell adenoma, hyperprolactinemia can be associated with

Rx (methyl-dopa, reserpine) that interfere with DA

Stalk effect from regional tumors preventing hypothalamic inhibition

pregnancy

24

most common cause of primary hyperparathyroidism

parathyroid adenoma

25

brown tumors of hyperparathyroidism, morphology

aggregates of osteoclasts, giant cells, and hemorrhagic debris

 

26

2 cell types of parathyoid gland

general morphology

cheif cells

oxyphil cell

 

consists of lobules with intervening adipocytes

27

adrenocortical carcinoma is dx by finding

invasion or metastases

28

osteoitisfibrosacystica

caused by hyperparathyroidism

cystic lesiosn caused by bone resoprtion leading to

thinned cortex and

marrow fibrosis with

cystic degeneration

29

bone manifestations of hyperparathyroidism result from _____ and include ___ and ____

result from osteoclast activation

 

include osteitisfibrosacystica and brown tumors

31

Rathke cleft cyst

cysts lined by ciliated cuboidal cells with scattered goblet cells and anterior pituitary cells

 

a cause of hypopituitarism

32

adrenocortical carcinoma morphology

large size with invasion 

lymph node mettases common 

compact cells, nuclear atypia, necrosis

33

most common pituitary tumor

prolactin cell adenoma