PitNET

Pituitary Neuroendocrine Tumor click to access explanations in the original CAP template

Useful information to be included from the case notes:
1. Clinical history
2. Functional status
3. Tumor sizes from imaging
4. Tumor extent or invasive growth from imaging

- Procedure:
- Tumor integrity:
- Tumor size:

Microscopic descriptions:

- Tumor histology:

- Tumor Number:	For multiple pituitary neuroendocrine tumors, repeat the following 5 elements for each distinct pituitary neuroendocrine tumor: 1. Tumor Types and Subtypes, 2. Tumor Proliferative Activity, 3. Histologically Confirmed Invasion, 4. Histochemical Features, and 5. Immunohistochemical Features. This section can be repeated up to 10 times.
1. Tumor Types and Subtypes:
	TPIT-lineage pituitary neuroendocrine tumor (corticotroph tumor) Densely granulated corticotroph tumor Sparsely granulated corticotroph tumor TPIT-lineage pituitary neuroendocrine tumor (corticotroph tumor), Crooke cell tumor TPIT-lineage pituitary neuroendocrine tumor (corticotroph tumor), Other (specify):
	PIT1-lineage pituitary neuroendocrine tumor Somatotroph tumor, densely granulated Somatotroph tumor, sparsely granulated Lactotroph tumor, densely granulated Lactotroph tumor, sparsely granulated Thyrotroph tumor Mammosomatotroph tumor Mature PIT1-lineage plurihormonal tumor Immature PIT1-lineage tumor Acidophil stem cell tumor Mixed somatotroph and lactotroph tumor (specify subtype) Other (specify):
	SF1-lineage pituitary neuroendocrine tumor Gonadotroph tumor Other (specify):
	Pituitary neuroendocrine tumor of no distinct cell lineage Null cell tumor Unusual plurihormonal (multilineage) pituitary neuroendocrine tumors (specify) Pituitary neuroendocrine tumor, NOS Other (specify):
2. Tumor Proliferative Activity:
	- Ki-67 Labeling Index: Selecting multiple small hot spots (at least 500 tumor cells) from different hot spot regions of the tumor rather than a single larger area of the same tumor are recommended.
	+ Mitotic Count (per 2 mm²): Using 22 mm eyepiece at 40x objective, count active proliferative areas for 42 fields (equals 10 mm²), divide by 5 to get mitotic count for 2 mm²
3. Histologically Confirmed Invasion:
4. + Histochemical stains:

	+ Reticulin Histochemistry
	+ PAS Histochemistry
5. Immunohistochemical studies
	- TPIT
	- PIT1
	- SF1
	+ GATA3
	+ ER-alpha
	+ alpha-subunit
	- ACTH (TPIT-tumors)
	- GH (PIT1-tumors)
	- PRL (PIT1-tumors)
	- beta-TSH (PIT1-tumors)
	+ beta-FSH
	+ p27
	+ ATRX
	+ p53
	- Low Molecular Weight Keratins Extent of Reactivity: Pattern of Reactivity: Fibrous bodies (accounting for greater than 70% of the tumor) Fibrous bodies (variable / scattered, accounting for less than 70% of the tumor) Perinuclear cytoplasmic Diffuse dense cytoplasmic Ring-like cytoplasmic Membranous Other (specify):

Metastasis: Not applicable Not identified Cerebrospinal (specify site(s)): Bone (specify): Liver (specify): Other (specify): Cannot be determined:

Non-tumorous Pituitary Site(s):

Not applicable Not identified Adenohypophysis identified Adenohypophysis identified, Crooke’s Hyaline Change of the Non-tumorous Corticotrophs (required for all corticotroph tumors) Adenohypophysis identified, + Pituitary Hyperplasia Neurohypophysis identified Cannot be determined (explain): Other (specify):

+ Additional pathologic findings:

Not applicable Not identified Hypophysitis (specify): Craniopharyngioma (specify type): Rathke’s cleft cyst (specify): Acute hemorrhagic necrosis (apoplexy) Other (specify):

- Additional notes: