The evolution in pituitary tumour classification: a clinical perspective
Objective: Pituitary tumours comprise a pathologically and clinically diverse group of neoplasms. Classification frameworks have changed dramatically in the past two decades, reflecting improving understanding of tumour biology. This narrative review examines the evolution of pituitary tumour classi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-06-01
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| Series: | Endocrine Oncology |
| Subjects: | |
| Online Access: | https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0079.xml |
| _version_ | 1797792349620797440 |
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| author | Nele F Lenders Peter E Earls Warrick J Inder Ann I McCormack |
| author_facet | Nele F Lenders Peter E Earls Warrick J Inder Ann I McCormack |
| author_sort | Nele F Lenders |
| collection | DOAJ |
| description | Objective: Pituitary tumours comprise a pathologically and clinically diverse group of neoplasms. Classification frameworks have changed dramatically in the past two decades, reflecting improving understanding of tumour biology. This narrative review examines the evolution of pituitary tumour classification, from a clinical perspective.
Results: In 2004, pituitary tumours were classified as ‘typical’ or ‘aty pical’, based on the presence of markers of proliferation, Ki67, mitotic count and p53. In 2017, the new WHO marked a major paradigm shift, with a new focus on lineage- based classification, determined by transcription factor and hormonal immunohistochemistry. The terms ‘typical’ and ‘atypical’ were omitted, though the importance of proliferative markers Ki67 and mitotic count was acknowledged. The recent WHO 2022 classification incorporates further refinements, specifically recognising some less common types that may represent less well-differentiated tumours. Whilst ‘high risk’ tumour types have been identified, further work is still required to improve prognostication.
Conclusions: Recent WHO classifications have marked significant progress in the diagnostic evaluation of pituitary tumours, though shortcomings and challenges remain for both clinicians and pathologists in managing these tumours. |
| first_indexed | 2024-03-13T02:31:54Z |
| format | Article |
| id | doaj.art-1e7d9d5ec16340d2b34d32badb0c595a |
| institution | Directory Open Access Journal |
| issn | 2634-4793 |
| language | English |
| last_indexed | 2024-03-13T02:31:54Z |
| publishDate | 2023-06-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Oncology |
| spelling | doaj.art-1e7d9d5ec16340d2b34d32badb0c595a2023-06-29T12:56:21ZengBioscientificaEndocrine Oncology2634-47932023-06-0131113https://doi.org/10.1530/EO-22-0079The evolution in pituitary tumour classification: a clinical perspectiveNele F Lenders0Peter E Earls1Warrick J Inder2Ann I McCormack3Department of Endocrinology, St Vincent’s Hospital, Sydney, NSW, Australia; Garvan Institute of Medical Research, Sydney, NSW, Australia; St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia Department of Anatomical Pathology and Cytopathology, St Vincent’s Pathology, Sydney, NSW, AustraliaDepartment of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Faculty of Medicine, the University of Queensland, Brisbane, QLD, Australia Department of Endocrinology, St Vincent’s Hospital, Sydney, NSW, Australia; Garvan Institute of Medical Research, Sydney, NSW, Australia; St Vincent’s Clinical School, University of New South Wales, Sydney, NSW, Australia Objective: Pituitary tumours comprise a pathologically and clinically diverse group of neoplasms. Classification frameworks have changed dramatically in the past two decades, reflecting improving understanding of tumour biology. This narrative review examines the evolution of pituitary tumour classification, from a clinical perspective. Results: In 2004, pituitary tumours were classified as ‘typical’ or ‘aty pical’, based on the presence of markers of proliferation, Ki67, mitotic count and p53. In 2017, the new WHO marked a major paradigm shift, with a new focus on lineage- based classification, determined by transcription factor and hormonal immunohistochemistry. The terms ‘typical’ and ‘atypical’ were omitted, though the importance of proliferative markers Ki67 and mitotic count was acknowledged. The recent WHO 2022 classification incorporates further refinements, specifically recognising some less common types that may represent less well-differentiated tumours. Whilst ‘high risk’ tumour types have been identified, further work is still required to improve prognostication. Conclusions: Recent WHO classifications have marked significant progress in the diagnostic evaluation of pituitary tumours, though shortcomings and challenges remain for both clinicians and pathologists in managing these tumours.https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0079.xmlpituitaryneuroendocrine tumoursimmunohistochemistrytranscription factors |
| spellingShingle | Nele F Lenders Peter E Earls Warrick J Inder Ann I McCormack The evolution in pituitary tumour classification: a clinical perspective Endocrine Oncology pituitary neuroendocrine tumours immunohistochemistry transcription factors |
| title | The evolution in pituitary tumour classification: a clinical perspective |
| title_full | The evolution in pituitary tumour classification: a clinical perspective |
| title_fullStr | The evolution in pituitary tumour classification: a clinical perspective |
| title_full_unstemmed | The evolution in pituitary tumour classification: a clinical perspective |
| title_short | The evolution in pituitary tumour classification: a clinical perspective |
| title_sort | evolution in pituitary tumour classification a clinical perspective |
| topic | pituitary neuroendocrine tumours immunohistochemistry transcription factors |
| url | https://eo.bioscientifica.com/view/journals/eo/3/1/EO-22-0079.xml |
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