Bugalho M J, Nunes J F, Sobrinho L G, Medina E, Campos J A, da Silva C G, Clode A L
Department of Endocrinology, Instituto Português de Oncologia, Lisboa.
Acta Endocrinol (Copenh). 1993 Mar;128(3):289-92. doi: 10.1530/acta.0.1280289.
Preoperative bilateral and simultaneous catheterization of the inferior petrosal sinuses was performed in a patient with Cushing's syndrome. This procedure revealed parallel intersinus gradients for ACTH, PRL, GH and a response of all these hormones to CRH. The patient had transphenoidal surgery and a soft white-yellowish mass occupying the whole sella conditioned a total hypophysectomy. Morphologic studies and immunostaining techniques revealed a rare mixed pituitary adenoma of ACTH and GH containing cells and failed to demonstrate PRL immunoreactivity in the tumor cells. These results are of clinical and speculative interest. Whether GH and PRL secretion in response to CRH stems from the tumor or reflect hormone release by non-tumor cells via a paracrine effect remains to be defined.
对一名库欣综合征患者进行了术前双侧同时岩下窦插管。该操作显示促肾上腺皮质激素（ACTH）、催乳素（PRL）、生长激素（GH）的窦间梯度平行，且所有这些激素对促肾上腺皮质激素释放激素（CRH）均有反应。患者接受了经蝶窦手术，一个占据整个蝶鞍的软质白黄色肿块导致了全垂体切除术。形态学研究和免疫染色技术显示，这是一种罕见的同时含有促肾上腺皮质激素细胞和生长激素细胞的混合性垂体腺瘤，肿瘤细胞中未显示催乳素免疫反应性。这些结果具有临床和推测意义。生长激素和催乳素对促肾上腺皮质激素释放激素的反应是源于肿瘤，还是通过旁分泌作用反映非肿瘤细胞释放的激素，仍有待确定。
