{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:14:16Z","timestamp":1789010056727,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T00:00:00Z","timestamp":1724544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain Pathology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The evolution of classification systems of pituitary adenomas (now PitNETs) has culminated in the use of transcription factor (TF) immunohistochemistry (IHC), forming a cell lineage\u2010based system. However, several issues remain to be addressed, including the additional financial and logistic burden of undertaking the complete array of anterior pituitary hormones and TF IHC. To that end, several groups have suggested algorithms to minimise the number of tests performed, with varying levels of diagnostic accuracy. Although the proportion of null cell tumours has decreased following the use of TFs, \u201cmultilineage\u201d tumours have been reported and characterised using transcriptomic signatures, most prominently the PIT1\u2010SF1 co\u2010expressing PitNETs, which do not bear a position in the present system of classification. In this review, we examine the proposed practical approaches to the diagnosis of PitNETs. We review the literature on reported PitNET types that challenge the existing classification system, such as those that express multiple TFs, with their potential clinical implications. Finally, we assess limitations in the present system, such as the lack of a standardised system for IHC interpretation, that need to be addressed in the future.<\/jats:p>","DOI":"10.1111\/bpa.13298","type":"journal-article","created":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T20:43:56Z","timestamp":1724618636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Practical approaches to diagnosing\n                    <scp>PitNETs<\/scp>\n                    \/adenomas based on cell lineage"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5564-2690","authenticated-orcid":false,"given":"Abhijit","family":"Goyal\u2010Honavar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery National Institute of Mental Health and Neurosciences (NIMHANS)  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2705-4717","authenticated-orcid":false,"given":"Geeta","family":"Chacko","sequence":"additional","affiliation":[{"name":"Neuropathology, Department of Pathology Christian Medical College  Vellore India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,25]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"WHO classification of tumours editorial board. Endocrine and neuroendocrine tumours [Internet]","author":"Asa SL"},{"key":"e_1_2_9_3_1","unstructured":"Brat DJ Lopes MB Mete O Osamura RY Asa SL Kleinschmidt\u2010DeMasters BK et al. Pituitary adenoma\/Pituitary Neuroendocrine Tumour. In: WHO Classification of Tumours Editorial Board. Central nervous system tumours. [Internet] Lyon (France): International Agency for Research on Cancer; 2021. [cited 2022 Jan 31]. (WHO classification of tumours series 5th ed.; Vol. 6). 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