Scheithauer B W, Kovacs K, Randall R V, Ryan N
Arch Pathol Lab Med. 1985 Jun;109(6):499-504.
Primary hypothyroidism is associated with hypertrophy and hyperplasia of thyrotropic cells. In addition, pituitary adenomas that produce thyroid-stimulating hormone occur in both hypothyroidism and hyperthyroidism. The relationship between thyrotropic hyperplasia and adenoma formation is, however, unsettled. We summarize the results of a histologic and immunocytologic study of the pituitary glands of 64 patients with long-standing primary hypothyroidism in an effort to characterize the changes in thyrotropic cells as related to the duration and severity of disease, to therapy, and to the development of thyrotropic adenomas. Diffuse and nodular thyrotropic cell hyperplasia was noted in 69% and 25% of glands, respectively. A crude correlation was observed between the degree of thyrotropic cell hyperplasia and the relative lack of thyroid hormone replacement therapy. In 12% of glands, tumorlet formation was observed, perhaps representing an intermediate stage between nodular hyperplasia and the development of microadenoma. Twelve adenomas were noted, five of which contained thyroid-stimulating hormone immuno-reactive cells. Although thyroid hormone deficiency seemed to selectively affect thyrotropic cells, lactotropic hyperplasia was observed in 20% of patients; the mechanism accounting for prolactin cell hyperplasia remains obscure.
原发性甲状腺功能减退与促甲状腺细胞肥大和增生有关。此外，产生促甲状腺激素的垂体腺瘤在甲状腺功能减退和甲状腺功能亢进患者中均有发生。然而，促甲状腺细胞增生与腺瘤形成之间的关系尚不清楚。我们总结了对64例长期原发性甲状腺功能减退患者垂体进行组织学和免疫细胞学研究的结果，以试图描述促甲状腺细胞的变化与疾病持续时间、严重程度、治疗以及促甲状腺腺瘤发生之间的关系。分别在69%和25%的腺体中发现了弥漫性和结节性促甲状腺细胞增生。促甲状腺细胞增生程度与甲状腺激素替代治疗相对不足之间存在粗略的相关性。在12%的腺体中观察到微腺瘤形成，这可能代表结节性增生与微腺瘤发生之间的中间阶段。发现了12例腺瘤，其中5例含有促甲状腺激素免疫反应性细胞。虽然甲状腺激素缺乏似乎选择性地影响促甲状腺细胞，但20%的患者出现了催乳素细胞增生；催乳素细胞增生的机制仍不清楚。
