792 J. P, SIMOKDS 



plasia," "struma," "adenoma" and "sarcoma" have frequently been used 

 by different authors for the same pathologic condition. 



In orcfer to establish some uniformity in the histologic diagnosis of 

 tumors of the anterior lobe of the hypophysis, the following terminology 

 is suggested as at least tentatively useful: 



(1) Hyperplasia. A moderate, uniform enlargement of the hy- 

 pophysis due to increase in size and number of the cells of the anterior 

 lobe. This term should be limited to those more or less physiological 

 enlargements of the hypophysis which accompany pregnancy, follow cas- 

 tration, or are frequently associated with hypothyroidism. The weight 

 of the gland rarely exceeds 1.5 grams. 



(2) Struma Pituitaria. In the sense in which the term was used 

 by Virchow namely, a uniform enlargement of the anterior lobe due to 

 multiplication of its cells. The size may vary from that seen in hyper- 

 plasia to several centimeters in diameter. 



(3) Adenoma. A sharply circumscribed growth composed of epi- 

 thelial cells, within the hypophysis. The hypophysis may or may not be 

 enlarged. That part of the anterior lobe outside the circumscribed nodule 

 has its normal histologic structure. 



(4) Carcinoma. A malignant epithelial tumor characterized by 

 multiplication of the cells of the anterior lobe, with invasion of the capsule 

 and adjacent structures. 



In each of the above types of hyperplasias and tumors a modifying 

 word or phrase, such as "chief cell," "eosinophil cell" or "basophil cell," 

 should be employed to designate the histogenesis of the process. 



(5) Sarcoma. This term should be limited to those malignant 

 tumors of the hypophysis in the cells of which granules cannot be demon- 

 strated by the special stains mentioned above. 



To determine the relative frequency of the different types of tumors 

 of the hypophysis is difficult because of the evident differences in the 

 nomenclature used by the various authors. The following table (I) is 

 based upon an analysis of records of 275 neoplasms of the hypophysis 

 collected from the literature together with a small number in my own col- 

 lection and in the Museum of Pathology of the Northwestern University 

 Medical School. In this table, I have included, under "Strumas," those 

 cases, other than pregnancy, castration and hypothyroidism, that had been 

 diagnosed "hyperplasia" or "hypertrophy" by the authors reporting them. 

 From this table it is seen that the tumors, in the order of their fre- 

 quency, are adenomas, 91; cranio-pharyngeal duct tumors, 50; strumas, 

 including the so-called hyperplasias, 39; and sarcomas, 38. It is certain 

 that many of the growths of the hypophysis that are classed in the table as 

 adenomas were strumas, and that many of those classed as sarcomas were 

 probably carcinomas. However, it was found impossible to attempt a 

 rediagriosis of so many of these new growths from the data in the records 



