Pituitary adenoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]


Pituitary adenoma may be classified according to the size of the adenoma and type of hormone secretion, subtypes include corticotrophic, somatotrophic, thyrotrophic, gonadotrophic, and lactrotrophic adenomas.


  • Historically, pituitary tumors were classified as basophilic, acidophilic, or chromophobic based on the positivity of hematoxylin and eosin stain.
  • Newer classification is based on either the size or the functional status of the adenoma (secretory vs. non-secretory).

Classification based on hormone secretion and immunohistochemical staining

Type of adenoma Secretion Staining Pathology
Corticotrophic adenomas Adrenocorticotropic hormone (ACTH) and pro-opiomelanocortin (POMC) Basophilic Cushing's disease
Somatotrophic adenomas Growth hormone (GH) Acidophilic Acromegaly (gigantism)
Thyrotrophic adenomas (rare) Thyroid-stimulating hormone (TSH) Basophilic Occasionally hyperthyroidism/Asymptomatic
Gonadotrophic adenomas Luteinizing hormone (LH), follicle-stimulating hormone (FSH) and their subunits Basophilic Asymptomatic
Lactrotrophic adenomas or prolactinomas (most common) Prolactin Acidophilic Galactorrhea, hypogonadism, amenorrhea, infertility, and impotence
Null cell adenomas Do not secrete hormones May stain positive for synaptophysin

Classification based on the size of the adenoma

Pituitary adenoma may be classified into 4 grades based on radioanatomical:

  • Stage I involves microadenomas (<1 cm) without sella expansion
  • Stage II involves macroadenomas (≥1 cm) and may extend above the sella
  • Stage III involves macroadenomas with enlargement and invasion of the floor or suprasellar extension
  • Stage IV involves macroadenomas that cause destruction of the sella


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