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British Medical Journal Feb 1935
PubMed: 20778876
DOI: 10.1136/bmj.1.3868.356 -
Clinics in Endocrinology and Metabolism Nov 1985The cytoplasmic secretory granules of corticotrophs in the anterior pituitary are basophil in trichrome stains and periodic acid-Schiff positive in the histochemical... (Review)
Review
The cytoplasmic secretory granules of corticotrophs in the anterior pituitary are basophil in trichrome stains and periodic acid-Schiff positive in the histochemical stain for glycoprotein due to their content of the glycosylated 16 000 N-terminal fragment of the precursor protein proopiomelanocorticotrophin (POC). The granules show a positive immunocytochemical reaction to antibodies raised against ACTH, beta-endorphin and N-terminal fragments of POC. A small subset of corticotrophs contains immunoreactive alpha MSH in addition. Immunocytochemistry shows the corticotrophs to constitute about 15-20% of the anterior pituitary cells arranged both singly and in clumps. They are distributed in the median wedge and anteriorly, laterally and posteriorly adjacent to the pars nervosa which is often 'invaded' by corticotroph basophils. The alpha MSH subset is prominent in the rudimentary intermediate lobe and is scattered anteriorly in the pituitary of the human fetus. Crooke cell hyalinization is associated with pathologically maintained hypercortisolaemia and with glucosteroid therapy. The hyalinization is demonstrated in ultrastructure to be due to massive accumulation of intermediate cytoplasmic filaments 7-8 nm in diameter that are normally present in only small number. The change is associated with a varying degree of loss of secretory granules. In untreated Addison's disease there is a marked increase in the number of corticotrophs, many of which are arranged in distended alveoli to form micronodules. The vast majority of cases of pituitary-dependent Cushing's disease and all cases of Nelson's syndrome are associated with a basophil or chromophobe adenoma. These give a positive immunocytochemical reaction with anti-ACTH, beta-endorphin and N-terminal POC. In ultrastructure the cells of the chromophobe adenomas are seen to contain sparse secretory granules that are usually smaller than those in the chromophil adenomas. There are only very few reports of pituitary-dependent Cushing's disease found to be due to immunocytochemically confirmed corticotroph hyperplasia with or without a corticotroph adenoma. A few cases have been described in which the adenoma cells show Crooke's hyalinization, associated in one example with secretion of a big ACTH found more typically in ectopic ACTH-secreting tumours. A group of cases due to corticotroph adenoma has been reported whose excessive ACTH secretion is reduced by treatment with the dopamine agonist bromocriptine, in which it is suggested that the tumour cells arise from a subset of corticotrophs of pars intermedia origin.(ABSTRACT TRUNCATED AT 400 WORDS)
Topics: Addison Disease; Adenoma; Adrenocorticotropic Hormone; Adult; Cushing Syndrome; Cytoplasmic Granules; Female; Histocytochemistry; Humans; Hyperplasia; Immunologic Techniques; Melanocyte-Stimulating Hormones; Microscopy, Electron; Pituitary Gland; Pituitary Gland, Anterior; Pituitary Neoplasms; Pro-Opiomelanocortin
PubMed: 3002676
DOI: 10.1016/s0300-595x(85)80077-3 -
The American Journal of Pathology Mar 1934
PubMed: 19970135
DOI: No ID Found -
Revista Medica Del Instituto Mexicano... Apr 2019Non-functional pituitary adenomas (NFPAs) present low growth rates; however, some are aggressive and invasive. In 2017 the World Health Organization recognized...
BACKGROUND
Non-functional pituitary adenomas (NFPAs) present low growth rates; however, some are aggressive and invasive. In 2017 the World Health Organization recognized clinically aggressive adenomas as “high-risk pituitary adenomas”. These include the sparsely granulated somatotroph adenoma, the Crooke’s cell adenoma, the silent corticotroph adenoma and the plurihormonal Pit-1-positive adenoma (subtype 3).
CLINICAL CASE
25-year-old woman who presented oligomenorrhea, increased weight, decreased visual acuity and chronic headache. Biochemical and imaging evaluation showed a NFPA. Transsphenoidal surgery was performed with complete resection of lesion, and during short-term follow-up it was observed recurrence, which is why the patient needed two more interventions. The immunohistochemistry reported: ACTH ++ 90%, prolactin ++ 20%, GH ++ 5%, CKAE1-AE3 +++ 90%, Ki-67 10%. The final diagnosis was plurihormonal adenoma, since the immunohistochemical analysis was positive for more than one pituitary hormone and suggested two distinct cell lineages: Pit-1 and Tpit, both recognized as aggressive adenomas.
CONCLUSIONS
This case report highlights the significance of a comprehensive immunohistochemical study, which includes transcriptional factors to classify cell lineage, in order to predict aggressiveness and provide personalized treatment.
Topics: Adenoma; Adult; Biomarkers, Tumor; Female; Growth Hormone-Secreting Pituitary Adenoma; Humans; Immunohistochemistry
PubMed: 31071255
DOI: No ID Found -
Ear, Nose, & Throat Journal Mar 2006
Topics: Adenoma; Adenoma, Acidophil; Adenoma, Basophil; Humans; Pituitary Neoplasms; Sphenoid Sinus
PubMed: 16615592
DOI: No ID Found -
Arquivos Brasileiros de Endocrinologia... Nov 2007
Topics: Adenoma, Basophil; Cortisone; Cushing Syndrome; History, 20th Century; Neurosurgery; Pituitary Neoplasms; Rheumatic Diseases; United States
PubMed: 18209854
DOI: 10.1590/s0004-27302007000800002 -
Journal of Perioperative Practice Sep 2012In 1932 Harvey Cushing published an article entitled 'Basophil adenomas of the pituitary and their clinical manifestations'. These are rare tumours of the anterior...
In 1932 Harvey Cushing published an article entitled 'Basophil adenomas of the pituitary and their clinical manifestations'. These are rare tumours of the anterior pituitary gland, at the base of the brain, with striking manifestations, which include adiposity of the face and trunk, but not the limbs, weakness, fatigue, abdominal striae, facial hair, high blood pressure and raised blood sugar. Although I spent two years in an army neurosurgical unit, I never saw a case. More frequently, the same clinical picture is produced by a benign adenoma of the suprarenal cortex, but today by far the commonest cause of this condition is seen in the patient receiving high dosage of cortisone, when we talk about the person exhibiting 'Cushingoid features'. Most readers of this journal will have seen such cases.
Topics: History, 20th Century; Pituitary ACTH Hypersecretion
PubMed: 23101174
DOI: 10.1177/175045891202200906 -
European Journal of Endocrinology Sep 2000
Review
Topics: Adenoma, Basophil; Adrenocorticotropic Hormone; Animals; Aspartic Acid Endopeptidases; Cushing Syndrome; Humans; Mice; Neoplasm Proteins; Nerve Tissue Proteins; Neuroendocrine Secretory Protein 7B2; Pituitary Hormones; Pituitary Neoplasms; Pro-Opiomelanocortin; Proprotein Convertase 2; Proprotein Convertases; Subtilisins
PubMed: 11022170
DOI: 10.1530/eje.0.1430313 -
Clinical Endocrinology May 1992
Review
Topics: Adenoma, Basophil; Cushing Syndrome; Humans; Hypothalamic Diseases; Pituitary Neoplasms; Prolactinoma
PubMed: 1319857
DOI: 10.1111/j.1365-2265.1992.tb02244.x -
The Laryngoscope May 1979One hundred and nine cases of cerebrospinal fluid rhinorrhea occurring over a ten-year period are reviewed. Experience with the use of fluorescein localization...
One hundred and nine cases of cerebrospinal fluid rhinorrhea occurring over a ten-year period are reviewed. Experience with the use of fluorescein localization techniques in 45 cases is detailed. The simplicity, easy availability and safety of fluorescein techniques are stressed. Primary rhinologic repair is advocated.
Topics: Adenoma, Basophil; Adenoma, Chromophobe; Adolescent; Adult; Aged; Cerebrospinal Fluid Rhinorrhea; Facial Injuries; Female; Fluoresceins; Fractures, Bone; Fractures, Closed; Humans; Male; Meningitis; Middle Aged; Pituitary Neoplasms; Wounds and Injuries
PubMed: 221763
DOI: 10.1288/00005537-197905000-00021