Pathway
Pathway Diagram
Images
Image Gallery
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Pituitary Microadenoma
Image 1a (T1 weighted), 1b and 1c (T2 weighted) (Magnetic Resonance Imaging): There is a lesion seen within the pituitary gland centred to the right of the midline which is of high signal intensity on the T2 weighted imaging and shows slightly reduced signal intensity compared with adjacent pituitary on the T1 weighted imaging. Overall, the lesion measures up to 6mm. The lateral aspect of the lesion is abutting the medial aspect of the cavernous segment of the right internal carotid artery. The superior aspect of the pituitary is directly adjacent to the inferior aspect of the optic chiasm. The appearances are consistent with a pituitary microadenoma.
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Pituitary Macroadenoma
Image 2a and 2b: Post-mortem specimens showing a circumcribed nodular tumour arising from the anterior pituitary consistent with a macroadenoma.
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Image 2c (H&E, x2.5) and 2d (H&E, x20): Histological sections demonstrating a circumscribed lesion composed of sheets of uniform polygonal cells with centrally placed nuclei and amphophilic cytoplasm. The features are consistent with a pituitary adenoma.
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Teaching Points
Teaching Points
- Diagnostic Imaging may reveal a cause of secondary amenorrhoea in the following cases
- Central hypogonandism where a functioning or non-functioning pituitary adenoma is present
- Ultrasonography of the ovaries in suspected polycystic ovarian syndrome or primary ovarian failure
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Pelvic Ultrasound
- Safe and non-invasive method to assess for uterine and ovarian pathology which may account for up to 20% of cases of secondary amenorrhea
- Most common uterine cause is intrauterine adhesions (Asherman syndrome) and should be considered particularly in women with a history of instrumentation
- Assessment of the ovaries may reveal small ovaries (ovarian failure) or polycystic ovaries (polycystic ovarian syndrome)
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Copyright
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Please remember that this leaflet is intended as general information only. It is not definitive and The Department of Health, Western Australia can not accept any legal liability arising from its use. The information is kept as up to date and accurate as possible, but please be warned that it is always subject to change
