Clore J N, Sharpe A R, Sahni K S, Kovacs K, Blackard W G
Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond.
Am J Med Sci. 1988 Jan;295(1):3-5. doi: 10.1097/00000441-198801000-00002.
A 36-year-old woman with hyperthyroidism, elevated blood thyroid-stimulating hormone (TSH) and alpha-subunit levels, amenorrhea, hyperprolactinemia and no evidence of acromegaly, was found to have a pituitary adenoma containing TSH, alpha-subunit and growth hormone by immunohistochemistry. Preoperative testing revealed elevated TSH and alpha-subunit with no response to thyrotropin-releasing hormone (TRH) but a normal response in prolactin to TRH. Culture of the pituitary cells showed release of TSH, alpha-subunit and prolactin. In vitro, TRH failed to cause TSH discharge; however, it increased prolactin concentrations in the culture medium. Triiodothyronine, added to the pituitary cell culture, resulted in no inhibition of TSH and prolactin discharge. By electron microscopy, the adenoma cells showed features of thyrotrophs. However, some adenoma cells contained fibrous bodies characteristic of some growth hormone cell tumors and acidophil stem cell adenomas, suggesting that the adenoma originated in a common progenitor cell.
一名36岁女性，患有甲状腺功能亢进、血液中促甲状腺激素（TSH）和α亚基水平升高、闭经、高催乳素血症且无肢端肥大症证据，经免疫组织化学检查发现垂体腺瘤含有TSH、α亚基和生长激素。术前检查显示TSH和α亚基升高，对促甲状腺激素释放激素（TRH）无反应，但催乳素对TRH反应正常。垂体细胞培养显示TSH、α亚基和催乳素释放。在体外，TRH未能引起TSH释放；然而，它增加了培养基中催乳素的浓度。添加到垂体细胞培养物中的三碘甲状腺原氨酸未导致TSH和催乳素释放受到抑制。通过电子显微镜检查，腺瘤细胞显示出促甲状腺细胞的特征。然而，一些腺瘤细胞含有一些生长激素细胞瘤和嗜酸性干细胞腺瘤特有的纤维体，提示该腺瘤起源于共同的祖细胞。
