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Endocrine Journal Oct 1993The patient was a 26-year-old man with Cushing's disease who underwent transsphenoidal microscopic surgery for a pituitary microadenoma. His postoperative course was...
The patient was a 26-year-old man with Cushing's disease who underwent transsphenoidal microscopic surgery for a pituitary microadenoma. His postoperative course was uneventful, but he died suddenly five years after the operation. At autopsy, a ruptured dissecting aneurysm with marked atherosclerosis was observed in the aorta. In the pituitary, a small focus of adrenocorticotropic hormone (ACTH) producing adenoma, possibly residual adenoma, was detected and Crooke's degeneration was observed in the non-tumorous pituitary gland. But immunohistochemical patterns of pituitary hormones in the non-tumorous pituitary gland were normal and the adrenal cortex was unremarkable. In the hypothalamus, corticotropin-releasing hormone immunoreactivity was not detected and arginine vasopressin was sporadically positive. Considering these findings, this patient may have developed subclinical hypercortisolism due to the residual adenoma at the time of autopsy, despite clinical remission. Cushing's syndrome is considered to be a risk factor dissecting aneurysm, and in this case the metabolic changes in Cushing's disease may have influenced the development of the dissecting aneurysm. Periodic cardiovascular re-evaluations should therefore be performed when there is clinical remission of Cushing's syndrome.
Topics: Adenoma, Basophil; Adrenocorticotropic Hormone; Adult; Aortic Dissection; Aortic Aneurysm; Aortic Rupture; Arginine Vasopressin; Arteriosclerosis; Corticotropin-Releasing Hormone; Cushing Syndrome; Death, Sudden; Fatal Outcome; Humans; Hypertension; Hypothalamo-Hypophyseal System; Hypothalamus; Male; Microsurgery; Neoplasm Recurrence, Local; Pituitary Gland, Anterior; Pituitary Neoplasms; Pituitary-Adrenal System; Postoperative Complications
PubMed: 7951528
DOI: 10.1507/endocrj.40.613 -
The American Journal of Pathology May 1976
Topics: Adenoma, Acidophil; Adenoma, Basophil; Adenoma, Chromophobe; Animals; Cell Line; Disease Models, Animal; Humans; Pituitary Hormones, Anterior; Pituitary Neoplasms; Rats
PubMed: 178187
DOI: No ID Found -
The American Journal of Pathology Mar 1980Among 300 surgically removed pituitary adenomas, 17 tumors containing immunoreactive 1-39 adrenocorticotropin (ACTH) and/or 19-39 ACTH, beta-lipotropin, and...
Among 300 surgically removed pituitary adenomas, 17 tumors containing immunoreactive 1-39 adrenocorticotropin (ACTH) and/or 19-39 ACTH, beta-lipotropin, and alpha-endorphin but unassociated with clinical signs of Cushing's disease have been detected. These neoplasms were divided into basophilic adenomas with strong periodic acid-Schiff (PAS) and lead-hematoxylin positivity and chromophobic tumors with moderate or no PAS and lead-hematoxylin positivity. The former were densely granulated tumors with a fine structure strikingly similar to that of functioning corticotropic cell adenomas. The latter were sparsely granulated with varying ultrastructural patterns. The marked morphologic diversity suggests that these adenomas, despite their similar immunocytologic characteristics, represent more than one entity. Clinically, the most common finding was a rapidly progressing visual defect. An unusually high incidence of infarction (5 cases) and recurrence (5 cases) was noted, underlining the importance of correct morphologic diagnosis and careful follow-up.
Topics: Adenoma; Adenoma, Basophil; Adenoma, Chromophobe; Adrenocorticotropic Hormone; Adult; Aged; Endorphins; Female; Histocytochemistry; Humans; Male; Middle Aged; Pituitary Gland; Pituitary Neoplasms; beta-Lipotropin
PubMed: 6244736
DOI: No ID Found -
Molecular Pathology : MP Feb 2002In the pituitary gland, activating mutations of the GNAS1 (Gsalpha) gene at Gln227 have been identified in adrenocorticotrophin secreting, growth hormone secreting, and...
In the pituitary gland, activating mutations of the GNAS1 (Gsalpha) gene at Gln227 have been identified in adrenocorticotrophin secreting, growth hormone secreting, and prolactin secreting adenomas. To date, mutations at the codon encoding R201, typically underlying the McCune-Albright syndrome and isolated fibrous dysplasia of bone, have been demonstrated only in growth hormone secreting pituitary adenomas. In this study, a polymerase chain reaction amplified target sequence in exon 8 of the GNAS1 gene was sequenced, identifying the first R201 mutation seen in an isolated basophilic adenoma which generated Cushing's disease in a child. This case adds Cushing's disease to the range of human diseases caused by R201 mutations of the GNAS1 gene.
Topics: Adenoma, Basophil; Child; Cushing Syndrome; DNA Mutational Analysis; Female; GTP-Binding Protein alpha Subunits, Gs; Humans; Mutation, Missense; Oncogene Proteins; Pituitary Neoplasms
PubMed: 11836449
DOI: 10.1136/mp.55.1.58 -
The American Journal of Pathology Aug 1984Crooke's hyaline change was studied by immunocytochemistry using an anti-adrenocorticotropic hormone (ACTH) antiserum and five different antisera against cytokeratins....
Crooke's hyaline change was studied by immunocytochemistry using an anti-adrenocorticotropic hormone (ACTH) antiserum and five different antisera against cytokeratins. Crooke's hyaline appears in basophil cells of the adenohypophysis in patients with hypercortisolism, presumably as a part of the negative feedback on corticotropin secretion. Previous studies have identified the hyaline material as a simple protein, apparently unrelated to ACTH, and electron microscopy has revealed a loss of secretory granules and an accumulation of 6-9-nm filaments in the cytoplasm of affected cells. In this study, the secretory granules in adenohypophysial cells exhibiting Crooke's hyaline change were labeled by anti-ACTH antibodies, while the hyaline material was positive for cytokeratin with each of the five antisera used. The results suggest that high levels of glucocorticoids may stimulate elaboration of cytokeratins in basophils while they suppress the production and release of ACTH.
Topics: Adenoma, Basophil; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Aged; Cytoplasmic Granules; Cytoskeleton; Female; Humans; Hyalin; Immune Sera; Keratins; Male; Microscopy, Electron; Middle Aged; Pituitary Gland, Anterior; Pituitary Neoplasms
PubMed: 6205591
DOI: No ID Found -
British Journal of Cancer Mar 1960
Topics: Adenoma; Animals; Basophils; Gonads; Neoplasms; Pituitary Gland; Pituitary Neoplasms; Rats
PubMed: 13829276
DOI: 10.1038/bjc.1960.6 -
Neurologia Medico-chirurgica Oct 1989A case of pituitary apoplexy causing pituitary hemorrhage with extension into the third ventricle is reported. The patient was a 73-year-old, obese female admitted with...
A case of pituitary apoplexy causing pituitary hemorrhage with extension into the third ventricle is reported. The patient was a 73-year-old, obese female admitted with sudden onset of vomiting and impaired consciousness. Neurological examination revealed that she was stuporous, with marked neck stiffness and a dilated left pupil. A plain skull X-ray showed sellar enlargement and destruction of the dorsum sellae. Computed tomography demonstrated a high-density area in the third and lateral ventricles and a round, high-density mass in the suprasellar cistern. The patient died the next day. Autopsy revealed a large tumor in the sellar and suprasellar areas. The tumor and the hematoma within it compressed the floor of the third ventricle and passed through the lamina terminalis and the hypothalamic region. Histological examination disclosed a basophilic adenoma. The pituitary hemorrhage appeared to be the result of ischemia and necrosis within the pituitary adenoma caused by its acute expansion. The extension of the hematoma into the third ventricle was attributable to the large size of the tumor and its close adhesion to the floor of third ventricle.
Topics: Adenoma, Basophil; Aged; Cerebral Ventricles; Female; Humans; Pituitary Apoplexy; Pituitary Neoplasms
PubMed: 2482940
DOI: 10.2176/nmc.29.908 -
Neurologia Medico-chirurgica Mar 1983
Topics: Adenoma, Basophil; Adult; Cerebral Hemorrhage; Cushing Syndrome; Female; Hematoma; Humans; Hypertension; Pituitary Neoplasms; Putamen
PubMed: 6193449
DOI: 10.2176/nmc.23.223 -
The American Journal of Pathology May 1938
PubMed: 19970391
DOI: No ID Found -
The American Journal of Pathology Oct 1982Thirteen pituitary adenomas were removed from patients with Cushing's disease by the transphenoidal route. All cases demonstrated a typical histochemical and...
Thirteen pituitary adenomas were removed from patients with Cushing's disease by the transphenoidal route. All cases demonstrated a typical histochemical and ultrastructural pattern. Immunocytochemical study by means of the immunoperoxidase technique and light or electron microscopy demonstrated 1-24/1-39 adrenocorticotropic hormone (ACTH) in all cases, lipotropin/melanotropin (beta-LPH/beta-MSH) in 10 cases, beta-endorphin in 8 cases, and an absence of calcitonin in all cases. In addition, in 2 cases tumor tissue contained a few antiprolactin immunoreactive cells. These ACTH, beta-LPH, and beta-endorphin immunoreactivities may reflect either the peptides themselves or their precursors or intermediate products. The authors also suggest a possible intermediate-lobe-like processing of beta-LPH leading to beta-endorphin production, which may act on PRL cells. In addition, no positive arguments for the existence of a common precursor for calcitonin and ACTH could be provided from this study.
Topics: Adenoma; Adenoma, Acidophil; Adenoma, Basophil; Adenoma, Chromophobe; Adolescent; Adult; Cushing Syndrome; Female; Histocytochemistry; Humans; Immunochemistry; Immunoenzyme Techniques; Immunologic Techniques; Male; Microscopy, Electron; Middle Aged; Pituitary Neoplasms
PubMed: 6289670
DOI: No ID Found