Quantitative analysis of the pituitary fossa and gland in Cushing's disease.

With tomography and encephalography of 78 cases with primary Cushing's disease, changes in the appearance of the pituitary gland and fossa have been demonstrated in greater numbers than previously reported. One or more direct or indirect signs of enlargement of the pituitary gland either by hyperplasia, microadenoma, or adenoma occurred in 60 per cent. Most of these cases were unproved as to cell type because they were given proton beam therapy. There were more cases of pituitary enlargement in those with adrenalectomy in comparison to non-adrenalectomy cases and in those with pigmentation in comparison to non-pigmented cases. The high incidence of pituitary gland enlargement in the different phases of this disease supports the importance of this gland in the pathogenesis of primary Cushing's disease. Limitation in correlation of the pituitary fossa to size of the pituitary gland when the latter enlarges only slightly has been discussed.