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Pituitary gland anatomy pathology

Robert Fenstermaker, Ajay Abad
PURPOSE OF REVIEW: This article reviews sellar and parasellar anatomy and the appearance of normal bone and soft tissue components on both CT and MRI. Pituitary gland structure and function are discussed with respect to hormone secretion, along with clinical syndromes caused by perturbations in hormone levels. Syndromes and specific diseases in the sellar and parasellar regions are discussed along with characteristic clinical features and imaging findings. RECENT FINDINGS: Bone and calcifications are best visualized with CT scans, while soft tissues are better defined using MRI...
October 2016: Continuum: Lifelong Learning in Neurology
Gregory K Hong, Spencer C Payne, John A Jane
The pituitary gland functions prominently in the control of most endocrine systems in the body. Diverse processes such as metabolism, growth, reproduction, and water balance are tightly regulated by the pituitary in conjunction with the hypothalamus and various downstream endocrine organs. Benign tumors of the pituitary gland are the primary cause of pituitary pathology and can result in inappropriate secretion of pituitary hormones or loss of pituitary function. First-line management of clinically significant tumors often involves surgical resection...
February 2016: Otolaryngologic Clinics of North America
Akira Inomata, Hironobu Sasano
The adrenal gland has characteristic morphological and biochemical features that render it particularly susceptible to the actions of xenobiotics. As is the case with other endocrine organs, the adrenal gland is under the control of upstream organs (hypothalamic-pituitary system) in vivo, often making it difficult to elucidate the mode of toxicity of a test article. It is very important, especially for pharmaceuticals, to determine whether a test article-related change is caused by a direct effect or other associated factors...
July 2015: Journal of Toxicologic Pathology
N A Guk, E Skobskaya, L Yu Pilipas, A Yu Malysheva, T A Malysheva
Results of treatment of 17 patients, operated primarily for adenoma of hypophysis (AH) using endoscopic transnasal access in clinic of transsphenoidal surgery of hypophysis adenoma, were analyzed. Anatomical variants of paranasal cavities (PNC) and preoperative criteria in accordance to the CT data, determining tactics of endoscopic interventions and technical peculiarities of its separate stages are adduced. While comparing MRI data on the stage of preoperative planning and multispiral CT (MSCT) PNC with additional layings of a patient detailed information about their variative anatomy was achieved...
March 2015: Klinichna Khirurhiia
Rachel Shields, Rajiv Mangla, Jeevak Almast, Steven Meyers
The sellar and juxtasellar regions in the paediatric population are complex both anatomically and pathologically, with magnetic resonance imaging (MRI) being the "gold standard" imaging modality due to the high contrast of detail. Assessment requires a detailed understanding of the anatomy, embryology, pathophysiology and normal signal characteristics of the pituitary gland and surrounding structures in order to appropriately characterise abnormalities. This article aims to provide an overview of the imaging characteristics of developmental/congenital and acquired disease processes which affect the sellar and juxtasellar region in the paediatric population...
April 2015: Insights Into Imaging
José M Pascual, Ruth Prieto, Paolo Mazzarello
Sir Victor Horsley (1857-1916) is considered to be the pioneer of pituitary surgery. He is known to have performed the first surgical operation on the pituitary gland in 1889, and in 1906 he stated that he had operated on 10 patients with pituitary tumors. He did not publish the details of these procedures nor did he provide evidence of the pathology of the pituitary lesions operated on. Four of the patients underwent surgery at the National Hospital for Neurology and Neurosurgery (Queen Square, London), and the records of those cases were recently retrieved and analyzed by members of the hospital staff...
July 2015: Journal of Neurosurgery
Haritha Pottipalli Sathyanarayana, Vignesh Kailasam, Arun B Chitharanjan
The sella turcica is a structure which can be readily seen on lateral cephalometric radiographs and sella point is routinely traced for various cephalometric analyses. The search was carried out using the following key words (sella turcica, bridging of sella, size, shape of sella turcica) and with the following search engine (Pubmed, Cochrane, Google scholar). The morphology is very important for the cephalometric position of the reference point sella, not only for evaluating craniofacial morphology, but also when growth changes and orthodontic treatment results are to be evaluated...
September 2013: Dental Research Journal
Joshua W Lucas, Gabriel Zada
The sellar and parasellar region is anatomically complex and encompasses many important vascular, endocrine, and neural structures. Pathology that arises within this region is often similarly complex, and requires a combination of endocrinologic, ophthalmologic, and neurologic examinations combined with advanced neuroimaging modalities. Magnetic resonance imaging (MRI) has become the gold standard for characterization of sellar and parasellar pathology due to the high contrast and detail it provides. Computed tomography (CT) allows for identification of bony involvement of lesions and also the general bony anatomy of the sellar region...
September 2012: Seminars in Neurology
Vicknes Waran, Roshni Menon, Devaraj Pancharatnam, Alwin Kumar Rathinam, Yuwaraj Kumar Balakrishnan, Tan Su Tung, Rajagopalan Raman, Narayanan Prepageran, Hari Chandran, Zainal Ariff Abdul Rahman
BACKGROUND: Surgical navigation systems have been used increasingly in guiding complex ear, nose, and throat surgery. Although these are helpful, they are only beneficial intraoperatively; thus, the novice surgeon will not have the preoperative training or exposure that can be vital in complex procedures. In addition, there is a lack of reliable models to give surgeons hands-on training in performing such procedures. METHODS: A technique using an industrial rapid prototyping process by three-dimensional (3D) printing was developed, from which accurate spatial models of the nasal cavity, paranasal sinuses (sphenoid sinus in particular), and intrasellar/pituitary pathology were produced, according to the parameters of an individual patient...
September 2012: American Journal of Rhinology & Allergy
R Shane Tubbs, Ha Son Nguyen, Mohammadali M Shoja, Brion Benninger, Marios Loukas, Aaron A Cohen-Gadol
PURPOSE: The medial tentorial artery (MTA) of Bernasconi-Cassinari has been associated with many neurosurgical pathologies, including tentorial and petroclival meningiomas, dural arteriovenous fistulae, hemangioblastomas, moyamoya disease, arteriovenous malformations, trigeminal neuromas, and malignant gliomas. This vessel may function as a source of collateral blood supply for the posterior circulation. Our goal was to elucidate the MTA by compiling information about it in one concise article for clinicians and neurosurgeons who need to know about the anatomy and clinical significance of this artery...
December 2011: Acta Neurochirurgica
U J Knappe, M Engelbach, K Konz, H-J Lakomek, W Saeger, R Schönmayr, W A Mann
OBJECTIVE: Localization of microadenomas in Cushing's disease may be difficult as in up to 45% of patients sellar MRI fails to detect a pituitary tumor. Intraoperative transsphenoidal ultrasound may identify microadenomas as hyperechoic structures. We report on the first 18 consecutive cases with intraoperative use of a new device for direct contact high-frequency-ultrasound in patients with Cushing's disease. PATIENTS AND TECHNIQUE: 18 patients (14 female, 4 male, age 24-71 years) with typical endocrinological findings for Cushing's disease were included in the study...
April 2011: Experimental and Clinical Endocrinology & Diabetes
R L Cecil
1. Anatomical lesions of the pancreas occur in more than seven-eighths of all cases of diabetes mellitus. 2. In diabetes associated with lesions of the pancreas, the islands of Langerhans constantly show pathological changes (sclerosis, hyaline degeneration, infiltration with leucocytes and hypertrophy). 3. In some cases of pancreatic diabetes (twelve of ninety cases) the lesion of the pancreas is limited to the islands of Langerhans. 4. In sixteen cases of diabetes associated with hyaline degeneration of the islands of Langerhans the average duration of the disease has been three and a half years; in forty-six cases with sclerosis of these bodies, three years and eleven months...
March 1, 1909: Journal of Experimental Medicine
Arnaud Dagain, Jean-François Lepeintre, Pietro Scarone, Ciprien Costache, Michel Dupuy, Stéphane Gaillard
BACKGROUND: Suprasellar arachnoid cysts are rare entities in adults, representing 10% of all cysts. Endoscopic treatment is now preferred for this pathology, allowing a new anatomical approach to skull base structures. OBJECTIVES: The aim of this study is to present the relevant anatomy of the skull base viewed during an endoscopic procedure for a suprasellar arachnoid cyst. METHOD: A 77-year-old man with 6 months history of walking disorder was referred for neurosurgical evaluation...
April 2010: Surgical and Radiologic Anatomy: SRA
Midge Ritchie, Anthony A Pilny
The endocrine system of birds is comparable to that of mammals, although there are many unique aspects to consider when studying the anatomy, physiology, and biochemistry. Avian endocrinology is a field of veterinary medicine that is unfamiliar to many practitioners; however, it is important to have a comprehensive understanding when evaluating companion birds in clinical practice. This article covers the anatomy and physiology of the normal avian, and readers are referred to other articles for a more detailed explanation of altered physiology and pathology...
January 2008: Veterinary Clinics of North America. Exotic Animal Practice
Sahar N Saleem, Ahmed-Hesham M Said, Donald H Lee
The hypothalamus is susceptible to involvement by a variety of processes, including developmental abnormalities, primary tumors of the central nervous system (CNS), vascular tumors, systemic tumors affecting the CNS, and inflammatory and granulomatous diseases. The hypothalamus may also be involved by lesions arising from surrounding structures such as the pituitary gland. Magnetic resonance (MR) imaging is the modality of choice for evaluating the anatomy and pathologic conditions of the hypothalamus. The MR imaging differential diagnosis depends on accurate anatomic localization and tissue characterization of hypothalamic lesions through the recognition of their signal intensity and contrast material enhancement patterns...
July 2007: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Stefan Wolfsberger, André Neubauer, Katja Bühler, Rainer Wegenkittl, Thomas Czech, Stephan Gentzsch, Hans-Gerd Böcher-Schwarz, Engelbert Knosp
OBJECTIVE: Virtual endoscopy (vE) is the navigation of a camera through a virtual anatomical space that is computationally reconstructed from radiological image data. Inside this three-dimensional space, arbitrary movements and adaptations of viewing parameters are possible. Thereby, vE can be used for noninvasive diagnostic purposes and for simulation of surgical tasks. This article describes the development of an advanced system of vE for endoscopic transsphenoidal pituitary surgery and its application to teaching, training, and in the routine clinical setting...
November 2006: Neurosurgery
Janine Rennert, Arnd Doerfler
The sellar and parasellar region is an anatomically complex area where a number of neoplastic, infectious, inflammatory, developmental and vascular pathologies can occur. Differentiation among various etiologies may not always be easy, since many of these lesions may mimic the clinical, endocrinologic and radiologic presentations of pituitary adenomas. The diagnosis of sellar lesions involves a multidisciplinary effort, and detailed endocrinologic, ophthalmologic and neurologic testing are essential. CT and, mainly, MRI are the imaging modalities to study and characterise normal anatomy and the majority of pathologic processes in this region...
February 2007: Clinical Neurology and Neurosurgery
Avi Mazumdar
The pituitary gland is housed in the sella turcica and has vital endocrinologic functions. It lies in close proximity to numerous vital structures, including the optic chiasm, sphenoid sinus, cavernous sinus and hypothalamus. An understanding of the function, anatomy and embryology of the pituitary gland and its surrounding structures is vital to understanding its normal appearance, as well as in evaluating the broad spectrum of pathology that can involve the pituitary gland. Imaging of pathology in the sellar region, including pituitary adenomas, meningiomas, craniopharyngiomas and aneurysms, plays an important role in guiding treatment decisions...
September 2006: Expert Review of Anticancer Therapy
Burak Sade, Gérard Mohr, Jean Lorrain Vézina
OBJECTIVE: This study was undertaken to assess the displacement patterns and shifts of the normal pituitary gland in sellar pathologies on MRI and to determine if the position of the bright spot (BS) represents a predicting factor for the position of the residual adenohypophysis (RAH) in pathological conditions. METHODS: In a control group of 102 patients without any pituitary pathology, the presence of the BS was evaluated. In 100 patients with intra- or suprasellar pathologies, presence and respective topography of BS and RAH were scrutinized on MRI, according to lesion type, size, endocrine status and intra-operative findings in the surgical group...
November 2004: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Roy Thomas Daniel, Gabriel Yin Foo Lee, Peter Lawrence Reilly
This 30-year-old woman presented with clinical symptoms and signs of intracranial hypertension and Parinaud syndrome secondary to ventriculoperitoneal shunt dysfunction. Magnetic resonance (MR) imaging revealed gross triventricular hydrocephalus with a large suprapineal recess due to aqueductal stenosis. Using an endoscopic approach, a ventriculostomy was performed within the floor of the dilated suprapineal recess. Following this procedure the patient experienced alleviation of all her neurological symptoms and signs...
September 2004: Journal of Neurosurgery
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