•Review of Normal Endocrine System
•Pituitary gland disease
1. Hyperpituitarism and pituitary adenomas
• Prolactinomas
• Growth hormone-producing (Somatotroph Cell) adenomas
• ACTH cell (corticotroph) adenomas
• Gonadotroph (LH-producing and FSH-producing) adenomas
• Thyrotroph (TSH-producing) adenomas
2. Hypopituitarism
3. Posterior Pituitary Syndromes
• Diabetes insipidus
• Syndrome of inappropriate ADH (SIADH) secretion.
•Thyroid Gland Disorders
4. Hyperthyroidism
5. Hypothyroidism
6. Thyroiditis
- Hashimoto thyroiditis
7. Diffuse and multinodular goiter
8. Neoplasms of the Thyroid
- Adenoma
- Carcinomas
•Adrenal Gland Disorders
9. Adrenocortical hyperfunction (hyperadrenalism)
- Hypercortisolism (Cushing Syndrome)
- Hyperaldosteronism
- Adrenogenital syndromes
10. Adrenocortical Insufficiency
- Primary acute adrenocortical insufficiency (adrenal crisis)
- Primary chronic adrenocortical insufficiency (Addison disease)
- Secondary adrenocortical insufficiency
11. Adrenal medulla disorder
- Pheochromocytome
,Pituitary Disease
•Clinical Manifestations:
Hyperpituitarism: Arising from excess secretion of trophic hormones.
- Causes: pituitary adenoma, hyperplasia and carcinomas of the anterior pituitary,
secretion of hormones by nonpituitary tumors, and certain hypothalamic disorders.
Hypopituitarism: Arising from deficiency of trophic hormones. (Not enough secretion)
- Causes: Destructive processes: including ischemic injury, surgery or radiation,
inflammatory reactions, and nonfunctional pituitary adenomas.
Local mass effects:
Radiographic abnormalities of the sella turcica.
- Including sellar expansion, bony erosion, and disruption of the diaphragma sella.
Visual field abnormalities:
- Classically bitemporal hemianopia: defects in the lateral (temporal) visual fields,
so-called.
- Damage to chiasm of optic nerve fibers
Elevated intracranial pressure
- Including headache, nausea, and vomiting.
Pituitary apoplexy:
- Acute hemorrhage into an adenoma is associated with clinical evidence of rapid
enlargement of the lesion and depression of consciousness. Acute pituitary
apoplexy is a neurosurgical emergency, since it can cause sudden death.
, 1. Pituitary Adenomas and Hyperpituitarism 腦下垂體腺瘤和腦下垂體機能亢進症
•The most common cause of hyperpituitarism 腦下垂體功能亢進症 is an adenoma arising
in the anterior lobe.
•Can be:
▫Functional: associated with hormone excess and clinical manifestations
▫Nonfunctional: immunohistochemical and/or ultrastructural demonstration of hormone
production at the tissue level, without clinical symptoms of hormone excess.
•Prolactinomas 催乳素瘤
- Are the most frequent type of hyperfunctioning pituitary adenoma.
- Accounting for about 30% of all clinically recognized cases.
- These lesions range from small microadenomas to large, expansile tumors
associated with substantial mass effect.
- Prolactin with cytoplasm of tumor cells 腫瘤細胞胞質中的催乳素
- Hyperprolactinemia:
Amenorrhea, galactorrhea, loss of libido, and infertility
•Growth hormone-producing (Somatotroph Cell) adenomas 產生生長激素（生長激素細
胞）的腺瘤
- The second most common type of functioning pituitary adenoma.
- Pure GH increase or accompany with other hormone increase (e.g. prolactin)
Persistently elevated levels of GH stimulate the hepatic secretion of insulin-like growth
factor 1 (IGF-1 or somatomedin C), which causes many of the clinical manifestations.
- Most important manifestations of excessive GH
E.g. gigantism (kids), acromegaly (adults)
- Other manifestation: DM, hypertension, osteoporosis.
•Pituitary gland disease
1. Hyperpituitarism and pituitary adenomas
• Prolactinomas
• Growth hormone-producing (Somatotroph Cell) adenomas
• ACTH cell (corticotroph) adenomas
• Gonadotroph (LH-producing and FSH-producing) adenomas
• Thyrotroph (TSH-producing) adenomas
2. Hypopituitarism
3. Posterior Pituitary Syndromes
• Diabetes insipidus
• Syndrome of inappropriate ADH (SIADH) secretion.
•Thyroid Gland Disorders
4. Hyperthyroidism
5. Hypothyroidism
6. Thyroiditis
- Hashimoto thyroiditis
7. Diffuse and multinodular goiter
8. Neoplasms of the Thyroid
- Adenoma
- Carcinomas
•Adrenal Gland Disorders
9. Adrenocortical hyperfunction (hyperadrenalism)
- Hypercortisolism (Cushing Syndrome)
- Hyperaldosteronism
- Adrenogenital syndromes
10. Adrenocortical Insufficiency
- Primary acute adrenocortical insufficiency (adrenal crisis)
- Primary chronic adrenocortical insufficiency (Addison disease)
- Secondary adrenocortical insufficiency
11. Adrenal medulla disorder
- Pheochromocytome
,Pituitary Disease
•Clinical Manifestations:
Hyperpituitarism: Arising from excess secretion of trophic hormones.
- Causes: pituitary adenoma, hyperplasia and carcinomas of the anterior pituitary,
secretion of hormones by nonpituitary tumors, and certain hypothalamic disorders.
Hypopituitarism: Arising from deficiency of trophic hormones. (Not enough secretion)
- Causes: Destructive processes: including ischemic injury, surgery or radiation,
inflammatory reactions, and nonfunctional pituitary adenomas.
Local mass effects:
Radiographic abnormalities of the sella turcica.
- Including sellar expansion, bony erosion, and disruption of the diaphragma sella.
Visual field abnormalities:
- Classically bitemporal hemianopia: defects in the lateral (temporal) visual fields,
so-called.
- Damage to chiasm of optic nerve fibers
Elevated intracranial pressure
- Including headache, nausea, and vomiting.
Pituitary apoplexy:
- Acute hemorrhage into an adenoma is associated with clinical evidence of rapid
enlargement of the lesion and depression of consciousness. Acute pituitary
apoplexy is a neurosurgical emergency, since it can cause sudden death.
, 1. Pituitary Adenomas and Hyperpituitarism 腦下垂體腺瘤和腦下垂體機能亢進症
•The most common cause of hyperpituitarism 腦下垂體功能亢進症 is an adenoma arising
in the anterior lobe.
•Can be:
▫Functional: associated with hormone excess and clinical manifestations
▫Nonfunctional: immunohistochemical and/or ultrastructural demonstration of hormone
production at the tissue level, without clinical symptoms of hormone excess.
•Prolactinomas 催乳素瘤
- Are the most frequent type of hyperfunctioning pituitary adenoma.
- Accounting for about 30% of all clinically recognized cases.
- These lesions range from small microadenomas to large, expansile tumors
associated with substantial mass effect.
- Prolactin with cytoplasm of tumor cells 腫瘤細胞胞質中的催乳素
- Hyperprolactinemia:
Amenorrhea, galactorrhea, loss of libido, and infertility
•Growth hormone-producing (Somatotroph Cell) adenomas 產生生長激素（生長激素細
胞）的腺瘤
- The second most common type of functioning pituitary adenoma.
- Pure GH increase or accompany with other hormone increase (e.g. prolactin)
Persistently elevated levels of GH stimulate the hepatic secretion of insulin-like growth
factor 1 (IGF-1 or somatomedin C), which causes many of the clinical manifestations.
- Most important manifestations of excessive GH
E.g. gigantism (kids), acromegaly (adults)
- Other manifestation: DM, hypertension, osteoporosis.
