Immunohistochemical Patterns of Pituitary Adenomas in Southeastern Nigeria, a 10-year Histopathologic Review

Figures & data

Table 1. Distribution of Intracranial Tumours in Enugu [2008–2017].

Intracranial Tumours	Frequency	Proportion (%)
Meningioma	199	38.9
Gliomas	158	30.9
Pituitary adenomas	100	19.6
Craniopharyngioma	18	3.5
Medulloblastoma	13	2.5
Haemangioblastoma	8	1.6
Choroid plexus papilloma	3	0.6
Pineoblastoma	3	0.6
Neurocytoma	2	0.4
High Grade Lymphoma	1	0.2
Neuroblastoma	1	0.2
Pineocytoma	1	0.2
Mixed pineocytoma and pineoblastoma	1	0.2
Atypical teratoid/rhabdoid tumour	1	0.2
Intracranial mature cystic teratoma	1	0.2
Pineal parencymal tumour of intermediate differentiation (WHO grade III)	1	0.2
Metastatic brain tumours	-	-
Total	511	100

Table 2. Age and sex distribution of pituitary adenomas in Enugu [2008–2017].

Variable	Frequency (N = 100)	Proportion (%)
Age Groups
<20 years	0	0.0
20–29 years	11	11.0
30–39 yrs	29	29.0
40–49 years	28	28.0
50–59 years	18	18.0
60–69 years	12	12.0
≥70	2	2.0
Sex
Male	55	55.0
Female	45	45.0
Total 100 100.0

Figure 1. Histologic patterns of pituitary adenomas in Enugu (2008–2017)..

Figure 2. Distribution of immunohistochemical subtypes of pituitary adenomas by sex in Enugu (2008–2017).

Figure 3. Photomicrographs of pituitary adenomas showing (a) acidophilic, (b) basophilic and (c) chromophobic adenomas [H&E stain x 400].

Figure 4. Photomicrographs of pituitary tissue showing (a) positive cytoplasmic staining with growth hormone monoclonal antibody in normal pituitary gland [Positive GH Immunostain x 400], (b) positive cytoplasmic staining with growth hormone monoclonal antibody in pituitary adenoma [Positive GH Immunostain x 400], (c) positive cytoplasmic staining with prolactin hormone monoclonal antibody in pituitary adenoma [Prolactin Immunostain x 400] and (d) negative cytoplasmic staining in pituitary adenoma [Negative immunostain for all six antibodies x 400].

Figure 5. Photomicrographs of pituitary tissue showing (a) positive cytoplasmic staining with Thyroid Stimulating Hormone Monoclonal Antibody [TSH Immunostain x 400] (b) positive cytoplasmic staining with Adrenocorticotrophic Hormone Monoclonal Antibody [ACTH Immunostain x 400], (c) positive cytoplasmic staining with Follicle Stimulating Hormone Monoclonal Antibody [FSH Immunostain x 400] and (d) positive cytoplasmic staining with Luteinizing Hormone Monoclonal Antibody [LH Immunostain x 400].

Table 3. Immunohistochemical subtypes of Pituitary Adenomas in Enugu, 2008–2017.

Variable	Frequency N = 100	Proportion (%)
Monohormonal
Null cell	44	44.0
PRL	27	27.0
LH	13	13.0
FSH	7	7.0
GH	3	3.0
TSH	2	2.0
ACTH	1	1.0
Plurihormonal
GH+TSH+LH	1	1.0
GH+LH	1	1.0
PRL+LH	1	1.0
Total	100	100.0

NB: PRL – prolactin, LH – luteinizing hormone, FSH – follicle stimulating hormone, GH – growth hormone, TSH – thyroid stimulating hormone, ACTH – adrenocorticotrophic hormone.

Table 4. Distribution of Immunohistochemical Subtypes of Pituitary Adenomas by Age, Sex and Biopsy Size in Enugu [2008–2017].

Variable	Null cell n = 44%)	PRL only n = 27%)	GH only n = 3%)	TSH only n = 2%)	ACTH only n = 1%)	FSH only n = 7%)	LH only n = 13%)	Plurihormonal n = 3%)	Total
Age groups (Years)
<20	-	-	-	-	-	-	-	-	0.0
20–29	6 (13.6)	5 (18.5)	-	-	-	-	-	-	11.0
30–39	13 (29.6)	5 (18.5)	2 (66.7)	-	1(100.0)	3(42.8)	4 (30.8)	1(33.3)	29.0
40–49	13(29.6)	9 (33.3)	1 (33.3)	1 (50.0)	-	1(14.3)	3(23.0)	-	28.0
50–59	5(11.3)	6 (22.2)	-	1 (50.0)	-	1(14.3)	4(30.8)	1(33.3)	18.0
60–69	6(13.6)	2 (7.4)	-	-	-	1(14.3)	2(15.4)	1(33.3)	12.0
≥70	1 (2.3)	-	-	-	-	1(14.3)	-	-	2.0
Sex
Male	25(56.8)	16 (59.3)	1 (33.3)	2 (100.0)	1(100.0)	2(28.6)	7 (53.8)	1(33.3)	55.0
Female	19(43.2)	11 (40.7)	2 (66.7)	-	-	5(71.4)	6(46.2)	2(66.6)	45.0
Biopsy size (cm)
<1	4 (9.1)	5 (18.5)	-	-	-	-	2 (15.4)	-	11
1–4	39(88.6)	21 (77.8)	3 (100.0)	2 (100.0)	1(100.0)	7(100.0)	11(84.6)	3(100.0)
>4	1(2.3)	1 (3.7)	-	-	-	-	-	-	2

Note: NB: PRL – prolactin, LH – luteinizing hormone, FSH – follicle stimulating hormone, GH – growth hormone, TSH – thyroid stimulating hormone, ACTH – adrenocorticotrophic hormone.