Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Best Pract Res Clin Endocrinol Metab. 2012 Aug;26(4):447-60. doi: 10.1016/j.beem.2012.01.002. Epub 2012 May 22.
Pituitary adenomas are classified by function as defined by clinical symptoms and signs of hormone hypersecretion with subsequent confirmation on immunohistochemical staining. However, positive immunostaining for pituitary cell types has been shown for clinically nonfunctioning adenomas, and this entity is classified as silent functioning adenoma. Most common in these subtypes include silent gonadotroph adenomas, silent corticotroph adenomas and silent somatotroph adenomas. Less commonly, silent prolactinomas and thyrotrophinomas are encountered. Appropriate classification of these adenomas may affect follow-up care after surgical resection. Some silent adenomas such as silent corticotroph adenomas follow a more aggressive course, necessitating closer surveillance. Furthermore, knowledge of the immunostaining characteristics of silent adenomas may determine postoperative medical therapy. This article reviews the incidence, clinical behavior, and pathologic features of clinically silent pituitary adenomas.
垂体腺瘤根据功能分类，由激素分泌过多的临床症状和体征定义，并随后通过免疫组织化学染色确认。然而，已经证明临床上无功能的腺瘤存在垂体细胞类型的阳性免疫染色，这种肿瘤被归类为无功能性腺瘤。这些亚型中最常见的包括无功能促性腺腺瘤、无功能促肾上腺皮质激素腺瘤和无功能生长激素腺瘤。不太常见的是，无功能泌乳素腺瘤和促甲状腺素腺瘤也会遇到。对这些腺瘤进行适当的分类可能会影响手术后的随访护理。一些无功能性腺瘤，如无功能促肾上腺皮质激素腺瘤，具有更具侵袭性的病程，需要更密切的监测。此外，对无功能性腺瘤的免疫染色特征的了解可能会决定术后的药物治疗。本文回顾了临床上无功能性垂体腺瘤的发病率、临床行为和病理特征。
