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    This classification was proposed by Touraine et al.Interestingly, some patients with primary hypertrophic osteoarthropathy eventually develop diseases (eg, patent ductus arteriosus, Crohn disease, myelofibrosis) that are otherwise known to be underlying causes of secondary hypertrophic osteoarthropathy, as late as 6-20 years after the onset of the osteoarthropathy.Observations made in modern times by Bamberger (1889), Pierre Marie (1890), and other investigators led to identification of various causes of this digital anomaly, which can be the first manifestation of a severe organic disease such as chronic pulmonary and cardiac diseases,.The disease is classified either as primary (hereditary or idiopathic) or secondary.She still dangles her magic wand; but due to weak batteries, the wand seldom works well.She is now thinking of using an Artificial Intelligence Robot to help her thinking and sometimes makes decisions on a behalf.These clinically nonfunctioning adenomas commonly present with signs and symptoms related to local mass effect, such as headaches, neurologic deficits of the cranial nerves (including visual field disturbances), and mild hyperprolactinemia due to pituitary stalk compression ("stalk effect"). Macroadenomas show an increased tendency toward suprasellar extension, gross invasion, and recurrence (see the following image).A radiologic classification proposed by Hardy Grossly, pituitary adenomas are soft lesions with a tan-brown discoloration.

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    Comparatively, primary tumors of the neurohypophysis are rare, and in general, they are similar to primary tumors of the central nervous system (CNS).

    The neurohypophysis, however, is a common site for metastases. Note the delicate acinar pattern of a normal pituitary gland (left), in contrast with disruption of the normal reticulin network in adenoma (right) (Wilder's reticulin stain).

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