Case contributed by A.Prof Frank Gaillard


None provided

Patient Data

Age: 55 years
Gender: Male

A circumscribed mass expands the pituitary fossa and stretches residual normal pituitary tissue around its periphery. There is no compression on the optic nerves or chiasm. 

Additionally, the corpus callosum appears mildly dysplastic. The rostrum is absent and the splenium small. 

Case Discussion

The patient went on to have a resection. 



The sections show a moderately hypercellular tumor. This is composed of lobules of cells with uniform round and oval vesicular nuclei and a variable amount of pale eosinophilic cytoplasm. Separate from the lobules, there is a haphazard arrangement of variably sized solid aggregates of tumor cells within a fibrous stroma. A narrow rim of normal anterior pituitary tissue is present along one edge of the tumor. No mitotic figures or areas of necrosis are identified.

Immunohistochemistry shows patchy strong staining in tumor cells for LH and there is strong diffuse nuclear staining for steroidogenic factor (SF-1). Tumor cells also show moderate staining for synaptophysin. Several small cystic structures, lined by Rathke's cleft type epithelium, are noted within the tumor. Epithelial cells lining these structures show strong cytoplasmic immunostaining for pancytokeratin AE1/AE3. Scattered S-100 +ve folliculo-stellate cells are noted admixed with tumor cells. No immunostaining for growth hormone, prolactin, ACTH, FSH, TSH, p40, GFAP, TTF-1, HBME-1 or cytokeratins CK7, CK20, CK5&6 and CK19 is seen in tumor cells. The topoisomerase labeling index is approximately 2%.


Silent gonadotroph cell pituitary macroadenoma.

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Case information

rID: 39642
Published: 26th Feb 2018
Last edited: 4th Nov 2018
Inclusion in quiz mode: Included

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