Tumour Type | Transcription Factor(s) | Hormone(s) | Keratin (CAM 5.2 or CK18) |
Tumour Subtype | Hormone Excess Syndrome |
PIT1 lineage tumours | |||||
Somatotroph tumours | PIT1 | GH, α-subunit | Perinuclear | Densely granulated somatotroph tumour | Florid acromegaly |
GH | Fibrous bodies (>70%) | Sparsely granulated somatotroph tumour | Subtle acromegaly | ||
Lactotroph tumours | PIT1, ERα | PRL (paranuclear) | Weak or negative | Sparsely granulated lactotroph tumour | Hyperprolactinemia |
PRL (diffuse cytoplasmic) | Weak or negative | Densely granulated lactotroph tumour | Hyperprolactinemia | ||
Mammosomatotroph tumour | PIT1, ERα | GH (often predominant) PRL, α-subunit | Perinuclear | Acromegaly and hyperprolactinemia | |
Thyrotroph tumour | PIT1, GATA2/3 | α-subunit, βTSH | Weak or negative | Hyperthyroidism | |
Mature plurihormonal PIT1-lineage tumour | PIT1, ERα, GATA2/3 | GH (often predominant), PRL, α-subunit, βTSH | Perinuclear | Acromegaly, hyperprolactinemia and hyperthyroidism |
|
Acidophil stem cell tumour | PIT1, ERα | PRL (predominant), GH (focal/variable) | Scattered fibrous bodies | Hyperprolactinemia ± subclinical acromegaly | |
Immature PIT1-lineage tumour | PIT1, ERα GATA2/3 | GH, PRL, α-subunit, βTSH | Focal/Variable | Acromegaly and/or Hyperprolactinemia and/or hyperthyroidism |
|
TPIT lineage tumours | |||||
Corticotroph tumours | TPIT (TBX19), NeuroD1/β2 | ACTH and other POMC derivatives | Strong | Densely granulated corticotroph tumour | Florid Cushing disease, often microtumour |
Variable | Sparsely granulated corticotroph tumour | Subtle Cushing disease, often macrotumour | |||
Intense ring-like perinuclear | Crooke cell tumour | Variable, Cushing disease but may be unusual |
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SF1 lineage tumours | |||||
Gonadotroph tumour | SF1, ERα GATA2/3 | α-subunit, βFSH, βLH | Variable | Hypogonadism (virtually
all) Hypergonadism (exceptional) |
|
Tumours without distinct cell lineage | |||||
Unclassified plurihormonal tumours | Multiple combinations | Multiple combinations | Variable | Variable | |
Null cell tumour | None | None | Variable | None |