Histologic and immunohistochemical study of clinically non-functioning pituitary adenomas: special reference to gonadotropin-positive adenomas.

Seventy-five clinically non-functioning pituitary adenomas were characterized in terms of their histologic and immunohistochemical features. Fourteen adenomas (18.7%) were positive for hormones other than gonadotropins. These included two somatotroph adenomas, three lactotroph adenomas, four thyrotroph adenomas, four corticotroph adenomas and one unusual plurihormonal adenoma. Fifty-five adenomas (73.3%) were exclusively positive for one or more gonadotropin subunits (beta-follicle stimulating hormone, beta-luteinizing hormone, and alpha-subunit of glycoprotein hormones), but negative for other hormones such as growth hormone and beta-thyrotropin. Histologically, a papillary arrangement along the capillary was most characteristically observed in the gonadotropin-positive adenomas. Five of six adenomas negative for any pituitary hormones exhibited the typical papillary structure. Thus, approximately 80% of clinically non-functioning adenomas constituted a single tumor group that shared the common histologic features of gonadotroph adenomas. These findings suggest that nearly all tumor types of clinically non-functioning adenomas can be diagnosed solely by light microscopy in combination with immunohistochemistry, and that the vast majority of them may be gonadotroph adenomas.