ArticleFrontiers in endocrinology2026
Acidophil stem cell-like pituitary neuroendocrine tumors with heterogeneous PIT1/SF1 or LH lineage-marker expression: a clinicopathological study of three cases.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Acidophil stem cell-like pituitary neuroendocrine tumors are uncommon PIT1-lineage tumors with heterogeneous morphology and immunophenotypes. Their distinction from other PIT1-lineage tumors and from tumors with additional gonadotroph-lineage-marker expression remains challenging. We retrospectively analyzed three surgically resected acidophil stem cell-like PitNETs. Clinical, endocrine, radiological, operative, histological, immunohistochemical, and follow-up data were reviewed. In cases 2 and 3, spatially matched serial sections were used to assess the relationship between PIT1 and SF1 expression. All patients were male and aged 17-48 years. The tumors showed PIT1 and PRL expression with variable GH expression. Case 1 showed LH positivity but was SF1-negative. Cases 2 and 3 showed SF1 positivity but were negative for FSH and LH. Spatially matched serial sections in cases 2 and 3 demonstrated PIT1-positive and SF1-positive nuclei in morphologically corresponding tumor-cell areas across consecutive serial sections, supporting PIT1/SF1 lineage-marker co-expression. All tumors showed radiological and/or intraoperative evidence of local invasiveness. The Knosp grades were bilateral grade 3 in case 1, grade 4 in case 2, and grade 1 in case 3. Early postoperative MRI showed no visible residual tumor in all cases. At the last available MRI follow-up, no recurrence or progression was identified after 14.7, 51.3, and 57.6 months in cases 1, 2, and 3, respectively. Acidophil stem cell-like PitNETs may show heterogeneous PIT1/SF1 or LH lineage-marker expression. Spatially matched serial-section analysis supports PIT1/SF1 co-expression in a subset of tumors; however, the biological significance and classification implications of this pattern require further study. Integrated interpretation of morphology, transcription factors, hormones, cytokeratin pattern, endocrine findings, radiological invasiveness, and longitudinal follow-up is essential.
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