Robert F, Hardy J
Semin Diagn Pathol. 1986 Feb;3(1):34-41.
Sixty-one pituitary corticotroph adenomas from 47 patients with Cushing's disease, 10 with Nelson's syndrome, and four eucorticoid patients were studied by light microscopy, immunoperoxidase, and electron microscopy. Seventy nine percent of all tumors and 70% of Nelson's cases were microadenomas, sometimes minute. A contiguity between the posterior lobe and the adenoma was seen in ten cases. Spontaneous infarction of the tumor with remission of Cushing's syndrome occurred in one case. Light microscopy revealed that the adenoma cells were basophilic and contained PAS-positive granules also staining with Herlant tetrachrome and lead-hematoxylin. The granules stained positively with antiserum to adrenocorticotrophic hormone (ACTH), beta-lipotropic hormones (beta-LPH) and beta-endorphin. The most characteristic ultrastructural finding was the presence of perinuclear bundles of microfilaments found in all our cases. Oncocytic changes were seen in three tumors. Four silent corticotroph adenomas, two of them originally microadenomas that had enlarged to enclosed adenomas while being treated with bromocriptine for hyperprolactinemia and one a large diffuse invasive tumor, did not differ in their microscopic, immunocytological, or ultrastructural features.
对47例库欣病患者、10例纳尔逊综合征患者和4例皮质醇正常患者的61个垂体促肾上腺皮质激素腺瘤进行了光镜、免疫过氧化物酶和电镜研究。所有肿瘤的79%以及纳尔逊综合征病例的70%为微腺瘤，有时非常微小。10例可见后叶与腺瘤相邻。1例肿瘤自发梗死，库欣综合征缓解。光镜显示腺瘤细胞嗜碱性，含有PAS阳性颗粒，也可被赫兰特四色染色法和铅苏木精染色。这些颗粒对促肾上腺皮质激素（ACTH）、β-促脂素（β-LPH）和β-内啡肽抗血清呈阳性染色。最具特征性的超微结构发现是在我们所有病例中均可见核周微丝束。3个肿瘤出现嗜酸性变。4个静止性促肾上腺皮质激素腺瘤，其中2个最初为微腺瘤，在使用溴隐亭治疗高泌乳素血症时增大为包膜内腺瘤，另1个为大的弥漫性侵袭性肿瘤，其镜下、免疫细胞学或超微结构特征无差异。
