Takemura T, Eishi Y, Hatakeyama S, Takahashi Y
Acta Pathol Jpn. 1983 Jan;33(1):159-67. doi: 10.1111/j.1440-1827.1983.tb02109.x.
An unusual case of Cushing's syndrome of a 59-year-old man with bilateral multinodular adrenal hyperplasia and microadenoma of the pituitary gland is presented. Failure to suppress plasma cortisol with large doses of dexamethasone may suggest autonomous growth of hyperplastic nodules of the adrenals, which were at first induced by prolonged stimuli of ACTH from the microadenoma of the pituitary gland. ACTH could not be detected in the microadenoma cells on paraffin sections, while Crooke's cells were strongly positive for ACTH. The interrelation between bilateral multinodular adrenal hyperplasia and pituitary microadenoma is discussed.
本文报告了一例59岁男性库欣综合征的罕见病例，该患者患有双侧多发性肾上腺增生和垂体微腺瘤。大剂量地塞米松未能抑制血浆皮质醇，这可能提示肾上腺增生结节的自主性生长，起初这些增生结节是由垂体微腺瘤分泌的促肾上腺皮质激素（ACTH）长期刺激所致。在石蜡切片上，垂体微腺瘤细胞中未检测到ACTH，而克罗克细胞对ACTH呈强阳性。本文还讨论了双侧多发性肾上腺增生与垂体微腺瘤之间的相互关系。
