Lamberts S W, Stefanko S Z, de Lange S A, Fermin H, van der Vijver J C, Weber R F, de Jong F H
J Clin Endocrinol Metab. 1980 Apr;50(4):793-5. doi: 10.1210/jcem-50-4-793.
A patient with Cushing's disease is described who underwent transsphenoidal adenomectomy of a basophilic microadenoma with a diameter of 3 mm. In a piece of surrounding normal pituitary tissue removed at operation, multiple small nests of adenomatous basophilic cells were found both in the adeno- and neurohypophysis. No clinical improvement was observed. Cortisol secretory rate, plasma ACTH, the absent response of plasma cortisol to insulin-induced hypoglycemia, and the responses of plasma cortisol to lysine vasopressin and TRH remained unchanged. The observations in this patient point to the presence of multiple ACTH-secreting adenomatous cell nests and microadenomas throughout pituitary gland and bring back into view the concept of primary stimulation of hypothalamic corticotropin-releasing factor as the primary derangement in some patients with Cushing's disease.
本文描述了一名库欣病患者，该患者接受了经蝶窦手术，切除了直径为3mm的嗜碱性微腺瘤。在手术中切除的一片周围正常垂体组织中，在腺垂体和神经垂体均发现了多个小巢状腺瘤性嗜碱性细胞。未观察到临床症状改善。皮质醇分泌率、血浆促肾上腺皮质激素（ACTH）、血浆皮质醇对胰岛素诱导的低血糖无反应，以及血浆皮质醇对赖氨酸加压素和促甲状腺激素释放激素（TRH）的反应均未改变。该患者的观察结果表明，整个垂体存在多个分泌ACTH的腺瘤性细胞巢和微腺瘤，这使人们重新审视下丘脑促肾上腺皮质激素释放因子的原发性刺激作为一些库欣病患者的主要紊乱因素这一概念。
