Scheithauer B W, Kovacs K, Randall R V
Arch Pathol Lab Med. 1983 Sep;107(9):484-7.
The pituitary glands of 18 patients with untreated Addison's disease were studied by histologic and immunocytochemical methods. Adrenal destruction was caused by tuberculosis (13 cases) or autoimmune adrenalitis (five cases), and the duration of the adrenal insufficiency ranged from one to 16 years. Both diffuse and nodular hyperplasia of corticotropic cells were evident in each case, and the extent of hyperplasia correlated with the duration of disease. In five cases, nodular proliferations with morphologic features between those of hyperplasia and those of adenoma, termed tumorlets, were identified, as were two microadenomas, only one of which was available for study. In all instances, the proliferating corticotrophs stained positively with PAS and were immunoreactive for adrenocorticotropic hormone and beta-endorphin. We conclude that diffuse and nodular corticotroph hyperplasia are common in untreated Addison's disease, although frank adenoma formation seems to be rare. The latter may be related to the short duration of disease or may imply the absence of additional, unknown factors that are required for adenoma growth.
采用组织学和免疫细胞化学方法对18例未经治疗的艾迪生病患者的垂体进行了研究。肾上腺破坏由结核病（13例）或自身免疫性肾上腺炎（5例）引起，肾上腺功能不全的病程为1至16年。在每例中促肾上腺皮质激素细胞的弥漫性和结节性增生均很明显，增生程度与病程相关。在5例中，发现了具有介于增生和腺瘤形态特征之间的结节性增殖，称为微腺瘤，还发现了2例微腺瘤，其中只有1例可供研究。在所有病例中，增生的促肾上腺皮质激素细胞PAS染色阳性，对促肾上腺皮质激素和β-内啡肽呈免疫反应性。我们得出结论，在未经治疗的艾迪生病中弥漫性和结节性促肾上腺皮质激素细胞增生很常见，尽管明显的腺瘤形成似乎很少见。后者可能与病程短有关，或者可能意味着缺乏腺瘤生长所需的其他未知因素。
