Novel aspects in histopathology of the pituitary gland

Pre- and Post- Clinical-Radiological and Surgical Evaluation Of Patients with Pituitary Adenoma and Metabolic Syndrome

Background. Pituitary adenomas are benign tumors located in the anterior hypophysis. It´s appearance is associated with the development of parameters related to metabolic syndrome; therefore, surgical treatment could reduce associated morbimortality.Methods. Pre- and post-surgical MRI, using the Hardy-Wilson and Knosp classification, and clinical data according to the American Association of Clinical Endocrinology (AACE) criteria for metabolic syndrome: all the patients were followed-up until 208.57 days were reviewed on 217 consecutive patients with pituitary surgery.Results. Seventy-four patients were included in this study. There was a significant reduction in tumor size in mm³ [average pre- and post-surgery respectively: 12,362 mm³ (± 12,397); 3,910 mm³ (± 7,160)], (p < 0.0001). This was confirmed by the Hardy-Wilson and Knosp classification, where most patients went from grade IV C (33.7%) to grade 0 (12.1%), IA (20.2%), IIB (21.36%), and IIC (16.2%); as well as from grade 4 (24.3%) to grade 0 (45.9%), respectively. After surgery, there were statistically significant reductions in total serum levels of glucose [average pre- and post-surgery respectively: 116 mg/dL (± 26.9); 90 mg/dL (±10.2)], (p < 0.001), triglycerides [average pre- and post-surgery, 240 mg/dL (± 102); 171 mg/dL (± 60.5)], (p = 0.001); and HDL-c [average pre- and post-surgery, respectively: 39 mg/dL (± 11.8); 44.6 mg/dL (± 8.4)], (p = 0.029). The other parameters remained unchanged.Conclusion. This is the first study to demonstrate the relationship between the presence of pituitary adenoma and significative changes in serum glucose, triglycerides and c-HDL related to metabolic syndrome.

Towards ultrahigh resolution OCT based endoscopical pituitary gland and adenoma screening: a performance parameter evaluation

Ultrahigh resolution optical coherence tomography (UHR-OCT) for differentiating pituitary gland versus adenoma tissue has been investigated for the first time, indicating more than 80% accuracy. For biomarker identification, OCT images of paraffin embedded tissue are correlated to histopathological slices. The identified biomarkers are verified on fresh biopsies. Additionally, an approach, based on resolution modified UHR-OCT ex vivo data, investigating optical performance parameters for the realization in an in vivo endoscope is presented and evaluated. The identified morphological features-cell groups with reticulin framework-detectable with UHR-OCT showcase a promising differentiation ability, encouraging endoscopic OCT probe development for in vivo application.