Pituitary specimens are frequently submitted for an intraoperative diagnosis being one of the most commonly handled neurosurgical specimens. Common indications for intraoperative assessment of sellar region lesions include the following: (1) ensure an appropriate tissue allocation and processing for accurate diagnosis, (2) confirm the presence of pituitary adenoma, (3) distinguish pituitary adenoma from other regional lesions, and (4) identify an unexpected lesion. Due to the peculiar location of the pituitary gland, just above the sphenoid sinus, a transnasal surgical approach is the rout by which biopsy or excision of most sellar lesions is performed. Because specimens obtained by this technique are slippery tiny fragments, cytologic preparations play a crucial diagnostic role on pituitary intraoperative consultation. In this chapter, the cytomorphologic features and differential diagnosis of neoplastic and nonneoplastic processes involving the pituitary gland/sellar region are revised.
KeywordsIntraoperative brain assessment Cytology Squash preparation Smear preparation Sellar lesions Sellar tumors Pituitary adenoma Invasive pituitary adenoma Pituitary carcinoma Craniopharingyoma Adamantinomatous craniopharyngioma Papillary craniopharyngioma Rathke cleft cyst Pituicytoma Granular cell tumor Spindle cell oncocytoma Pituitary blastoma Lymphocytic hypophysitis Hypothalamic hamartoma
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