McKenna T J, Glick A D, Cobb C A, Jacobs L S
Acta Endocrinol (Copenh). 1978 Feb;87(2):225-33. doi: 10.1530/acta.0.0870225.
A 38 year old man was investigated because of impotence, gynaecomastia and galactorrhoea. Hyperprolactinaemia and hypogonadism were documented. Pituitary function was otherwise normal as was tomographic examination of the sella turcica. In the absence of direct evidence of pituitary involvement (hyperprolactinaemia can suppress gonadal function) and to exclude ectopic prolactin production, venous blood was drawn at multiple sites. The highest prolactin levels were found in the superior vena cava and above, indicating an intracranial source. At transsphenoidal hypophysectomy a microadenoma was removed; tumour cells contained typical prolactin secretory granules on electron microscopy. In the light of this report the appropriateness of dividing hyperprolactinaemia into "tumourous" and "idiopathic" subgroups on the basis of sella size must be reconsidered. Functional tests do not distinguish between the subgroups although prolactin levels tend to be higher when the sella is enlarged. Only a quantitative rather than a qualitative difference may exist between the subgroups.
一名38岁男性因阳痿、男性乳房发育和溢乳接受检查。检查发现有高催乳素血症和性腺功能减退。垂体功能在其他方面正常，蝶鞍断层扫描也正常。在缺乏垂体受累的直接证据（高催乳素血症可抑制性腺功能）且为排除异位催乳素分泌的情况下，在多个部位采集静脉血。发现上腔静脉及以上部位的催乳素水平最高，提示为颅内来源。经蝶窦垂体切除术切除了一个微腺瘤；电镜检查显示肿瘤细胞含有典型的催乳素分泌颗粒。根据本报告，必须重新考虑基于蝶鞍大小将高催乳素血症分为“肿瘤性”和“特发性”亚组的合理性。功能测试无法区分这两个亚组，尽管蝶鞍增大时催乳素水平往往更高。这两个亚组之间可能仅存在数量上而非质量上的差异。
