Trouillas et al reported a classification for pituitary adenomas. The authors are from multiple institutions in France belonging to HYPOPRONOS.
Patient selection: pituitary adenoma
Characteristics:
(1) tumor diameter in mm on MRI
(2) tumor product type by immunohistochemistry
(3) tumor grade
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Tumor Diameter
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Term
|
|
< 10 mm
|
micro
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|
10 to 40 mm
|
macro
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> 40 mm
|
giant
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Tumor product type:
(1) growth hormone
(2) prolactin
(3) ACTH
(4) FSH/LH
(5) TSH
A tumor is termed invasive if there are signs of invasion into the cavernous or sphenoid invasion (on histology and/or MRI).
A proliferating adenoma has >= 2 of the following:
(1) Ki-67 increased (>= 3% in formalin fixed tissue; > 1% in Bouin-Hollande fixative)
(2) mitotic rate > 2 per 10 hpf
(3) p53 positive (> 10 strongly positive nuclei in 10 hpf)
The tumor is metastatic if there are cerebrospinal or systemic metastases.
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Invasive?
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Proliferating?
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Metastatic?
|
Grade
|
|
no
|
no
|
no
|
1a
|
|
no
|
yes
|
no
|
1b
|
|
yes
|
no
|
no
|
2a
|
|
yes
|
yes
|
no
|
2b
|
|
NA
|
NA
|
yes
|
3
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