Bazzoni N, Ambrosi B, Arosio M, Barbareschi M, Losa M, Faglia G
Istituto di Scienze Endocrine, University of Milano, Italy.
J Endocrinol Invest. 1990 Dec;13(11):931-5. doi: 10.1007/BF03349660.
Growth hormone overproduction is characterized by increased size of visceral organs as well as growth of bone and soft tissues. We describe a case of a 23-year-old female acromegalic patient, who had been previously unsuccessfully operated upon by transsphenoidal pituitary surgery and then irradiated. In November 1987 a routine X-ray chest examination revealed a mediastinal mass, subsequently confirmed by CT scan. The patient underwent surgical removal of the mass: macroscopical aspect, histological sections and immunocytochemistry showed typical thymic structures without any evidence of neurosecretory activity. No GH-positive cells were found and only small amounts of immunoreactive GHRH like material (9.2 ng/g wet wg) were detected in the tumor extract. Before surgery plasma GHRH levels were not elevated (26 pg/ml); serum GH and IGF-I levels were 27.4 +/- 4.9 micrograms/l and 191 nmol/l, respectively, and remained unchanged after surgery. These data ruled out a GHRH and/or GH ectopic production, confirming the primitive pituitary origin of acromegaly in this patient. It is likely that thymic hyperplasia may be explained by longstanding overproduction of GH and the young age of the patient.
生长激素分泌过多的特征是内脏器官增大以及骨骼和软组织生长。我们描述了一例23岁的女性肢端肥大症患者，该患者先前经蝶窦垂体手术治疗失败，随后接受了放射治疗。1987年11月，一次常规胸部X线检查发现纵隔肿块，随后经CT扫描证实。患者接受了肿块切除术：大体外观、组织学切片和免疫细胞化学显示为典型的胸腺结构，未发现任何神经分泌活动的证据。未发现生长激素阳性细胞，肿瘤提取物中仅检测到少量免疫反应性生长激素释放激素样物质（9.2 ng/g湿重）。手术前血浆生长激素释放激素水平未升高（26 pg/ml）；血清生长激素和胰岛素样生长因子-I水平分别为27.4±4.9μg/l和191 nmol/l，手术后保持不变。这些数据排除了生长激素释放激素和/或生长激素的异位分泌，证实了该患者肢端肥大症的原发性垂体起源。胸腺增生可能是由于长期生长激素分泌过多以及患者年龄较轻所致。
