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Miller MA, Piotrowski SL, Donovan TA, Scott-Moncrieff JC, Owen TJ, McCue JP, DuSold DM, Ramos-Vara JA, Weng HY, Chen AV, Martin LG, Bruyette DS. Feline Pituitary Adenomas: Correlation of Histologic and Immunohistochemical Characteristics With Clinical Findings and Case Outcome. Vet Pathol 2021; 58:266-275. [PMID: 33280571 PMCID: PMC10722206 DOI: 10.1177/0300985820978309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pituitary glands from 141 feline autopsy cases were reviewed histologically. Adenoma and hyperplasia were the most common lesions at 13 cases each. Pituitary adenoma was more likely than hyperplasia to be associated with clinical evidence of endocrinopathy or an intracranial mass (P < .001). A histochemical and immunohistochemical panel was applied to 44 autopsy- or hypophysectomy-derived pituitary adenomas in 43 cats from 2 diagnostic laboratories. Adenomas were differentiated from hyperplasia by the presence of disrupted reticulin fibers. One cat had a double (somatotroph and melanotroph) adenoma. Twenty somatotroph adenomas consisted of periodic acid-Schiff (PAS)-negative acidophils that expressed growth hormone; 16/20 had hypersomatotropism; 17/20 had diabetes mellitus. Eleven melanotroph adenomas consisted of PAS-positive basophils or chromophobes that expressed melanocyte-stimulating and adrenocorticotrophic hormones; 5/11 had hypercortisolism; 6/11 had diabetes mellitus. Eleven gonadotroph adenomas consisted of PAS-negative chromophobes that expressed follicle-stimulating and/or luteinizing hormones. Two thyrotroph adenomas consisted of PAS-negative basophils or chromophobes that expressed thyroid-stimulating hormone. Pituitary-dependent disease was not recognized in cats with gonadotroph or thyrotroph adenomas. The Ki-67 proliferation index in hypophysectomy specimens was lower in somatotroph than in melanotroph adenomas. Fourteen cats with hypophysectomy-treated somatotroph or melanotroph adenoma had an 899-day median survival time versus 173 days in 17 nonsurgical cases. After adjusting for age, adenoma size and type, hypophysectomized cats had an overall better survival time than nonsurgical cases (P = .029). The study results underscore the value of hypophysectomy and trophic hormone immunohistochemistry in the treatment and classification of feline pituitary adenomas.
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Affiliation(s)
| | - Stacey L. Piotrowski
- Purdue University, West Lafayette, IN, USA
- Comparative Biomedical Scientist Training Program, National Institutes of Health, Bethesda, MD, USA
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2
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Sanders K, Galac S, Meij BP. Pituitary tumour types in dogs and cats. Vet J 2021; 270:105623. [PMID: 33641809 DOI: 10.1016/j.tvjl.2021.105623] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/25/2022]
Abstract
Pituitary tumours are common in dogs and are being increasingly recognized in cats. Pituitary tumours are usually classified as adenomas and should only be classified as carcinomas when there is evidence of metastatic spread of the tumour, which is rare. Despite the benign nature of most pituitary tumours, they can still compress or invade neighbouring tissues. Pituitary tumours can be functional (hormonally active) or non-functional (hormonally silent). The aim of this review was to provide an overview of the different pituitary tumour types in dogs and cats that have been reported in the literature. In dogs, the most common pituitary tumour type is the corticotroph adenoma, which can cause pituitary-dependent hypercortisolism. In cats, the most common pituitary tumour is the somatotroph adenoma, which can cause hypersomatotropism, and the second-most common is the corticotroph adenoma. A lactotroph adenoma has been described in one dog, while gonadotroph, thyrotroph and null cell adenomas have not been described in dogs or cats. Hormonally silent adenomas are likely underdiagnosed because they do not result in an endocrine syndrome. Tools used to classify pituitary tumours in humans, particularly immunohistochemistry for lineage-specific transcription factors, are likely to be useful to classify canine and feline pituitary tumours of unknown origin. Future studies are required to better understand the full range of pituitary adenoma pathology in dogs and cats and to determine whether certain adenoma subtypes behave more aggressively than others. Currently, the mechanisms that underlie pituitary tumorigenesis in dogs and cats are still largely unknown. A better understanding of the molecular background of these tumours could help to identify improved pituitary-targeted therapeutics.
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Affiliation(s)
- K Sanders
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands.
| | - S Galac
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - B P Meij
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
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Polledo L, Grinwis GCM, Graham P, Dunning M, Baiker K. Pathological Findings in the Pituitary Glands of Dogs and Cats. Vet Pathol 2018; 55:880-888. [DOI: 10.1177/0300985818784162] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With the exception of classic functional adenomas in dogs and horses, pituitary lesions are infrequently described in the veterinary literature. Approximately 10% of pituitary glands from asymptomatic humans contain abnormalities, but the equivalent proportion in small animals is unknown. Pituitary glands from 136 dogs and 65 cats collected during routine necropsies were examined to determine the prevalence of pituitary lesions and their histopathological diagnosis. Lesions were characterized in sections stained with hematoxylin and eosin, periodic acid-Schiff (PAS), Gordon and Sweet’s and reticulin stains, and immunohistochemistry for adrenocorticotropic hormone (ACTH), growth hormone, melanocyte stimulating hormone–α, and prolactin. Pituitary abnormalities were identified in 36 of 136 (26.4%) dogs and 10 of 65 (15.3%) cats. Cystic changes were the most common lesion, occurring in 18 (13.2%) dogs and 8 (12.3%) cats. Pituitary neoplasia was detected in 14.1% (12/85) of middle-aged and old dogs; 1 (1.5%) cat had pituitary nodular hyperplasia. PAS and reticulin stains helped differentiate ACTH-immunoreactive adenomas from hyperplastic nodules: adenomas contained PAS-positive intracytoplasmic granules and loss of the normal reticulin network. One dog had a pituitary carcinoma with infiltration into the thalamus. Other pituitary abnormalities included secondary metastases (2 dogs) and hypophysitis (4 dogs, 1 cat). In most cases, the lesion appeared to be subclinical and could be considered incidental, whereas clinical manifestations were apparent in only 4 dogs (2.9%) and none of the cats with pituitary lesions. Pituitary abnormalities are common in dogs and cats, and their clinical relevance requires further investigation.
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Affiliation(s)
- Laura Polledo
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Guy C. M. Grinwis
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht, the Netherlands
| | - Peter Graham
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Mark Dunning
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | - Kerstin Baiker
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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Boland LA, Barrs VR. Peculiarities of feline hyperadrenocorticism: Update on diagnosis and treatment. J Feline Med Surg 2017; 19:933-947. [PMID: 28838299 PMCID: PMC11128894 DOI: 10.1177/1098612x17723245] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Practical relevance: Hyperadrenocorticism (HAC) is a relatively uncommon endocrinopathy of older cats, with a mean age at diagnosis of 10 years. In addition to pituitary-dependent and adrenal-dependent hypercortisolism, clinical signs of HAC can result from adrenal sex steroid-producing tumours. Clinical challenges: While HAC in cats has many similarities to canine HAC, there are key differences in presentation, diagnosis and response to therapy. Most, but not all, cats with HAC have concurrent diabetes mellitus, which is often insulin resistant. Up to a third of cats with HAC have extreme skin fragility and are at high risk of debilitating iatrogenic skin tears during diagnostic or therapeutic interventions. Infections of the skin and nail beds, and urinary, respiratory and gastrointestinal tract, secondary to cortisol-induced immune suppression, are also common. Cats respond differently to dogs to adrenal function tests including adrenocorticotropic hormone (ACTH) stimulation and dexamethasone suppression tests; a 10-fold higher dose of dexamethasone is recommended in cats to screen for HAC. Curative treatment options include adrenalectomy or transsphenoidal hypophysectomy. Radiation or medical treatment may improve clinical signs. The response to mitotane therapy is poor. While trilostane is the medical treatment of choice based on retrospective studies, investigations into the pharmacokinetics of this drug in cats are lacking. Global importance: Feline HAC occurs worldwide and is not associated with any purebreed predisposition. Although uncommon, adrenal sex steroid-producing tumours have a higher prevalence in cats than in dogs. Evidence base: The information in this review is drawn from over 180 reported cases of feline HAC. Reports investigating clinical presentation, clinicopathological findings and treatment outcomes are observational, retrospective multiple case series (EBM grade III) or single case reports (EBM grade IV). While most endocrine testing studies for diagnosis are cohort controlled analytical studies (EBM grade III), prospective, randomised, placebo-controlled studies have been performed (EBM grade I).
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Affiliation(s)
- Lara A Boland
- Valentine Charlton Cat Centre, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Vanessa R Barrs
- Valentine Charlton Cat Centre, Sydney School of Veterinary Science, Faculty of Science, and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, 2006, Australia
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Kimitsuki K, Boonsriroj H, Kojima D, Park CH. A case report of feline pituitary carcinoma with hypercortisolism. J Vet Med Sci 2013; 76:133-8. [PMID: 24025433 PMCID: PMC3979955 DOI: 10.1292/jvms.13-0373] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Feline pituitary tumors are rare. An 8-year-old male Japanese domestic cat presented with
anorexia and emaciation. The cat died 17 days after admission from progressive
neurological symptoms. At necropsy, a pituitary tumor measuring 25 × 18 × 15 mm was found.
Microscopically, the tumor was divided into multiple lobules and had grown invasively into
the adjacent brain tissue and sphenoid bone. Tumor cells had pleomorphic nuclei with
prominent centrally located nucleoli and abundant amphophilic polygonal cytoplasm.
Immunohistochemically, the tumor cells stained with anti-adrenocorticotropic hormone
(ACTH), α-melanin-stimulating hormone (MSH) and β-endorphin antibodies. Ultrastructurally,
the cytoplasm of the tumor cells contained various sized secretory granules. Based on
these pathological findings, this tumor was diagnosed as pituitary carcinoma originated
from pars intermedia cells.
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Affiliation(s)
- Kazunori Kimitsuki
- Department of Veterinary Pathology, School of Veterinary Medicine, Kitasato University, 23-35-1 Higashi, Towada, Aomori 034-8628, Japan
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Cross E, Moreland R, Wallack S. Feline Pituitary-Dependent Hyperadrenocorticism and Insulin Resistance Due to a Plurihormonal Adenoma. Top Companion Anim Med 2012; 27:8-20. [DOI: 10.1053/j.tcam.2011.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 12/05/2011] [Indexed: 11/11/2022]
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Meij BP, Auriemma E, Grinwis G, Buijtels JJCWM, Kooistra HS. Successful Treatment of Acromegaly in a Diabetic Cat with Transsphenoidal Hypophysectomy. J Feline Med Surg 2010; 12:406-10. [DOI: 10.1016/j.jfms.2010.03.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2010] [Indexed: 11/16/2022]
Abstract
Patient and surgical treatment An 11-year-old, castrated male cat was referred for insulin-resistant diabetes mellitus. It had a ravenous appetite, increased body weight, polyuria/polydipsia and a dull hair coat. The cat was receiving 25 IU insulin four times daily but blood glucose concentrations remained elevated. Plasma concentrations of growth hormone (GH) (51 μug/l, reference range 0.8–7.2 μg/l) and insulin-like growth factor 1 (IGF-1) (3871 μg/l, reference range 39–590 μg/l) were highly elevated, whereas those of alpha-melanocyte-stimulating hormone, adrenocorticotropic hormone and Cortisol were normal. Computed tomography revealed a thick palatum molle and an enlarged pituitary gland, indicating a pituitary neoplasm. Microsurgical transsphenoidal hypophysectomy was performed and microscopic examination of the surgical specimen revealed an acidophilic, infiltrative pituitary adenoma that showed positive immunostaining for GH. Outcome The clinical signs resolved and 3 weeks after surgery the cat no longer required insulin administration. One year after hypophysectomy the plasma concentrations of GH and IGF-1 were 2.4 μg/l and 113 μg/l, respectively. Practical relevance This is the first report detailing transsphenoidal hypophysectomy as a feasible and effective treatment for feline acromegaly due to a pituitary somatotroph adenoma. Moreover, in this patient, concurrent insulin-resistant diabetes mellitus resolved completely. The surgery is discussed in the context of human and other feline therapies for acromegaly.
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Affiliation(s)
- Björn P Meij
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, The Netherlands
| | - Edoardo Auriemma
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, The Netherlands
| | - Guy Grinwis
- Department of Pathology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, Utrecht, The Netherlands
| | - Jenny J C W M Buijtels
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, The Netherlands
| | - Hans S Kooistra
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, The Netherlands
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Slingerland LI, Voorhout G, Rijnberk A, Kooistra HS. Growth hormone excess and the effect of octreotide in cats with diabetes mellitus. Domest Anim Endocrinol 2008; 35:352-61. [PMID: 18801640 DOI: 10.1016/j.domaniend.2008.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 06/20/2008] [Accepted: 07/30/2008] [Indexed: 11/21/2022]
Abstract
In this prospective study 16 cats with diabetes mellitus were examined for concurrent acromegaly by measuring plasma growth hormone (GH) and insulin-like growth factor-I concentrations, and magnetic resonance imaging (MRI) of the pituitary fossa. Additionally, the effects of octreotide administration on the plasma concentrations of glucose, GH, alpha-melanocyte-stimulating hormone (alpha-MSH), adrenocorticotrophic hormone (ACTH), and cortisol were measured. Five cats were diagnosed with hypersomatotropism. The pituitary was enlarged in these 5 cats and in 2 other cats. Six cats that required a maximum lente insulin dosage >or=1.5 IU/kg body weight per injection had pituitary enlargement and 5 of these cats had acromegaly. Plasma concentrations of GH, ACTH, and cortisol decreased significantly after single intravenous administration of the somatostatin analogue octreotide in the acromegalic cats. The effect on GH concentrations was more pronounced in some of the acromegalic cats than in others. In the non-acromegalic cats only ACTH concentrations decreased significantly. In both groups plasma glucose concentrations increased slightly but significantly, whereas alpha-MSH concentrations were not significantly affected. In conclusion, the incidence of hypersomatotropism with concomitant pituitary enlargement appears to be high among diabetic cats with severe insulin resistance. Some of these cats responded to octreotide administration with a pronounced decrease in the plasma GH concentration, which suggests that octreotide administration could be used as a pre-entry test for treatment with somatostatin analogues.
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Affiliation(s)
- L I Slingerland
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
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Fracassi F, Mandrioli L, Diana A, Hilbe M, Grinwis G, Gandini G. Pituitary Macroadenoma in a Cat with Diabetes Mellitus, Hypercortisolism and Neurological Signs. ACTA ACUST UNITED AC 2007; 54:359-63. [PMID: 17718809 DOI: 10.1111/j.1439-0442.2007.00962.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 13-year-old neutered male European short-hair cat was presented because of blindness and behavioural abnormalities. On physical examination, abnormal behaviour, compulsive walking, circling, continuous vocalization and blindness were the main neurological signs. In addition, abdominal alopecia, thin and inelastic skin, weight loss despite polyphagia, polyuria and polydipsia were present. Laboratory investigation revealed diabetes mellitus and pituitary-dependent hypercortisolism. Diagnostic imaging showed bilaterally enlarged adrenals and a large pituitary mass. Histopathological and immunohistochemical examination confirmed the clinical diagnosis of an ACTH-producing pituitary macroadenoma.
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Affiliation(s)
- F Fracassi
- Veterinary Clinical Department, University of Bologna, Via Tolara di Sopra 50, 40064 Ozzano dell'Emilia (Bologna), Italy.
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Ohlerth S, Scharf G. Computed tomography in small animals – Basic principles and state of the art applications. Vet J 2007; 173:254-71. [PMID: 16516508 DOI: 10.1016/j.tvjl.2005.12.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2005] [Indexed: 10/24/2022]
Abstract
Since its clinical introduction, computed tomography (CT) has revolutionized veterinary medicine and is considered to be one of the most valuable tools for the imaging work-up of neurological, oncological and orthopaedic canine and feline patients. In small animals with acute trauma, particularly those involving complex anatomic areas such as the head, spine or pelvis, CT has been established as a standard imaging method. With the increasing availability of radiation therapy in veterinary medicine, CT has also become the principal tool to stage a tumour, assess response, and guide radiation therapy. The increasing availability of helical CT in veterinary medicine has allowed novel techniques such as spiral CT angiography and high-resolution CT. This review provides a brief overview of the historical and technical development of CT and literature reviews of the major clinical CT applications in small animals such as intracranial and extracranial lesions, the spine, the appendicular skeleton, and abdominal and thoracic diseases.
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Affiliation(s)
- Stefanie Ohlerth
- Section of Diagnostic Imaging and Radio-Oncology, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland.
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