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Global Translational Medicine Immunohistochemistry in pituitary adenomas

was performed on these sections for routine histological 2.5.2. Non-functioning adenomas
examination, allowing assessment of cellular morphology, Non-functioning adenomas do not secrete hormones at
growth patterns (solid, trabecular, or papillary), and tumor clinically significant levels. They are typically asymptomatic
classification (eosinophilic, amphophilic, or basophilic). until they grow large enough to cause mass effects, such as
Based on their staining properties, PAs are categorized headaches, visual disturbances, or hypopituitarism.
as: (i) eosinophilic, typically associated with GH or PRL
secretion, (ii) basophilic, which is often linked to ACTH 2.6. Statistical analysis
secretion, or (iii) amphophilic, which may show mixed Data analysis was performed using IBM Statistical Package
hormonal profiles. for Social Sciences for Windows, Version 23.0 (IBM Inc.,
The growth patterns of PAs (solid, trabecular, and United States). Continuous variables such as age and
papillary) are linked to specific tumor subtypes and clinical tumor size were presented as mean ± standard deviation.
behaviors: Descriptive statistics were used to summarize the clinical,
(i) Solid: These are NFPAs that are less aggressive but biochemical, and histopathological features of the PAs.
may cause mass effects.
(ii) Trabecular: These are GH-secreting (somatotroph) 3. Results
adenomas and prolactinomas.GH adenomas The cohort consisted of 40 patients (24 men and
are linked to acromegaly (50% invasive), while 16 women) with a mean age of 45 ± 6.5 years. The
prolactinomas are often invasive (43%). average tumor size was 13.2 ± 5.8 mm, with 87.5%
(iii) Papillary: These are ACTH-secreting (corticotroph) classified as macroadenomas (>10 mm) and 12.5% as
adenomas and plurihormonal adenomas. ACTH microadenomas (<10 mm). Among the patients, 30%
adenomas are associated with Cushing disease and required a second surgery due to tumor recurrence,
are often invasive, while plurihormonal adenomas while 17.5% underwent adjuvant radiotherapy. Eighty
have variable behavior. percentages of the patients received medical therapy

IHC staining was conducted using a panel of primary postoperatively, targeting hormonal control and tumor
antibodies targeting pituitary hormones, including GH, recurrence. Invasiveness, defined by Hardy Grade IV,
PRL, ACTH, TSH, FSH, and LH. The IHC protocol was identified in 40% of cases, while 60% were non-
involved antigen retrieval, blocking of non-specific binding, invasive or localized to intrasellar or extrasellar regions
and application of the primary antibodies, followed (Hardy Grades I-III) (Table 1).
by detection using standardized staining. IHC results Clinical symptoms varied according to the type of
were semi-quantitatively scored based on the number of PA. In prolactinomas (22.5%), women presented with
positively stained cells: 0 (Negative), 1+ (1 – 4 cells), 2+ amenorrhea, galactorrhea, and infertility in 75% of the
(5 – 20 cells), 3+ (21 – 50 cells), and 4+ (>51 cells). This cases. Patients with somatotroph adenomas (15%) exhibited
approach ensured a systematic evaluation of hormone
expression and correlation with histopathological findings. Table 1. Clinical baseline characteristics of patients and
pituitary adenomas
2.5. Categories of PAs
Characteristics Results (%)
2.5.1. Functioning adenomas
Age (years) 45±6.5
These tumors secrete one or more pituitary hormones, Gender
leading to specific clinical syndromes. They are further Men 24
classified based on the hormone they produce: Woman 16
(i) Prolactin-secreting adenomas: These can cause
hyperprolactinemia, leading to symptoms such as Diameter (mm) 13.2±5.8
galactorrhea, menstrual irregularities, and infertility Second surgery, n (%) 12 (30)
(ii) GH-secreting adenomas: These result in acromegaly Radiotherapy, n (%) 7 (17.5)
or gigantism due to excessive GH production Medical treatment, n (%) 32 (80)
(iii) ACTH-secreting adenomas: These lead to Cushing Invasiveness extension (Hardy), n (%)
disease, characterized by hypercortisolism Non- invasive
(iv) TSH-secreting adenomas: These can cause Intrasellar (I-II) 11 (27.5)
hyperthyroidism due to excessive TSH
(v) FSH/LH-secreting adenomas: These are often Extrasellar (III) 13 (32.5)
asymptomatic but may cause hormonal imbalances. Invasive (IV) 16 (40)

Volume 4 Issue 2 (2025) 98 doi: 10.36922/gtm.8474