McNicol A M, Teasdale G M, Beastall G H
Clin Endocrinol (Oxf). 1986 Jun;24(6):715-22. doi: 10.1111/j.1365-2265.1986.tb01668.x.
There is little evidence for a separate functional or anatomical intermediate lobe in the adult human pituitary gland. Nevertheless, Lamberts et al. (1982) proposed that a subgroup of corticotroph adenomas in Cushing's disease arise in that lobe and can be identified by the presence of argyrophil (? neural) fibres, and that these tumours are more often associated with corticotroph hyperplasia and hyperprolactinaemia than those arising in the anterior lobe. We have examined a series of corticotroph adenomas from patients with Cushing's disease for evidence of argyrophil fibres, and have correlated this with tumour site, corticotroph distribution in the para-adenomatous gland, serum PRL levels and PRL immunoreactive cells in the tumour. Argyrophil fibres were identified not only in tumours adjacent to the posterior lobe, but also in tumours situated deep in the anterior lobe. There was no correlation between the presence of fibres or the site of the tumour and corticotroph hyperplasia. Whilst the two patients with the highest serum PRL levels did have argyrophil fibres they also had a subpopulation of PRL immunoreactive cells in the tumour. On the basis of these results, we propose that the 'intermediate lobe' hypothesis as outlined above should not be accepted.
几乎没有证据表明成人人垂体中存在一个独立的具有功能或解剖学意义的中间叶。尽管如此，兰伯茨等人（1982年）提出，库欣病中的促肾上腺皮质激素腺瘤亚群起源于该叶，并且可以通过嗜银（？神经）纤维的存在来识别，而且这些肿瘤比起源于前叶的肿瘤更常与促肾上腺皮质激素细胞增生和高泌乳素血症相关。我们检查了一系列库欣病患者的促肾上腺皮质激素腺瘤，以寻找嗜银纤维的证据，并将其与肿瘤部位、腺瘤旁腺中促肾上腺皮质激素细胞的分布、血清泌乳素水平以及肿瘤中的泌乳素免疫反应性细胞进行了关联分析。嗜银纤维不仅在与后叶相邻的肿瘤中被发现，也在前叶深部的肿瘤中被发现。纤维的存在或肿瘤部位与促肾上腺皮质激素细胞增生之间没有相关性。虽然血清泌乳素水平最高的两名患者确实有嗜银纤维，但他们的肿瘤中也有一群泌乳素免疫反应性细胞。基于这些结果，我们认为上述“中间叶”假说不应被接受。
