Expression of hypothalamic corticotropin-releasing hormone-like immunoreactivity in isolated ACTH deficiency: a report of an autopsied case.

A 77-yr-old man died of metastising adenocarcinoma of the lung. He had been treated with hydrocortisone for isolated ACTH deficiency for 9 yr. At autopsy, the pituitary and the adrenal glands were atrophic. Lymphocyte infiltration was not observed in the pituitary, the adrenal and the thyroid glands. Immunohistochemistry revealed selective loss of ACTH-like immunoreactivity in the pituitary gland whereas CRH-immunoreactive cells were found in the paraventricular nucleus of the hypothalamus. This is the first report demonstrating immunohistochemical examinations of the pituitary and the hypothalamus in isolated ACTH deficiency.