Wednesday, March 22, 2017

An update on SF-1 driven pituitary adenomas

Adenomas driven by the transcription factor SF-1, which are exclusively gonadotroph adenomas, are a common subtype encountered by the surgical pathologist. Traditionally, gonadotroph adenomas have been defined by positive immunostaining for luteinizing hormone (LH) and/or follicle stimulating hormone (FSH) with or without alpha-subunit (αSU). However, evidence is now emerging that replacement of these three immunostains by the single SF-1 stain results in a more cost-effective and sensitive means of detecting gonadotrophin adenomas. Further, the majority of previously classified "null cell" adenomas -- negative for all hormonal markers including LH, FSH and αSU -- are in fact positive for SF-1 and therefore better classified as gonadotroph adenomas.

1 comment:

Wliam said...

Thanks for broadcasting this key observation! For those interested in simplifying and upgrading their pituitary adenoma diagnosis with SF-1 (and dropping routine use of LH, FSH, and ASU), we've included practical information, including clones, dilution, and antigen retrieval in our recently published paper in the Archives of Pathology and Laboratory Medicine. The full text of the paper is available at the link below.

Competing gold standards make for thorny and interesting diagnostic challenges. Our little paper takes a pragmatic approach to the question of how to design the "pit kit."

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