Adenoma of the human pituitary producing growth hormone and thyrotropin |
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Authors: | Kalman Kovacs Eva Horvath Calvin Ezrin Martin H Weiss |
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Institution: | (1) Department of Pathology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada;(2) Department of Medicine, Cedars Sinai Medical Center, UCLA Los Angeles California, USA;(3) Department of Neurosurgery, University of Southern California Los Angeles, California, USA |
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Abstract: | Summary A pituitary adenoma removed by surgery from a 22-year-old man was studied by histology, immunocytology, transmission electron microscopy and immunoelectron microscopy. Clinically, the patient had acromegaly and euthyroidism with elevated blood GH concentrations. Blood TSH and T4 levels were within the normal range. Histologically, the adenoma was chromophobic and exhibited no PAS, lead hematoxylin, aldehyde thionin or Grimelius silver positivity. By the immunoperoxidase technique GH, -TSH and -subunit but no PRL, ACTH, -endorphin, -FSH or -LH were demonstrated in the adenoma cells. Electron microscopy revealed adenoma cells which were similar to TSH cells and showed no resemblance to GH cells of nontumorous pituitaries or GH-secreting tumors. Immunoelectron microscopy demonstrated GH and -TSH in the secretory granules.It is concluded that pituitary adenomas composed of TSH-like cells may secrete GH, resulting in acromegaly. Production of GH by adenomatous TSH cells cannot be explained on the basis of the one cell- one hormone theory. The question is raised whether bihormonal or multihormonal clones, capable of synthesizing more than one hormone, exist in the human pituitary. These cells are apparently dormant under normal conditions, but in the course of neoplastic transformation may undergo functional dedifferentiation and acquire the ability to produce two or more different hormones. |
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Keywords: | Adenohypophysis Electron microscopy Growth hormone Immunocytology Pituitary adenoma Thyroid-stimulating hormone |
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