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Immunohistochemical and clinicoendocrinological studies of gonadotropin producing pituitary adenomas

, : Immunohistochemical and clinicoendocrinological studies of gonadotropin producing pituitary adenomas. No to Shinkei 44(8): 745-753

In order to study the secretion of gonadotropins in clinically non-functioning pituitary adenomas, 83 cases were investigated by immunohistochemistry. Expression of one or more of gonadotropin subunits (alpha-subunit, follicle-stimulating hormone (FHS) beta, lutenizing hormone (LH) beta) was found in 38 (45.8%) of all adenomas studied. alpha subunit and FHS beta were positive in 28 (33.7%) and 27 (32.5%) cases respectively, whereas LH beta was detected in seven (8.4%) adenomas. The presence of both alpha subunit and FSH beta was found in 17 cases, while alpha subunit was singly positive in 11 cases and FSH-beta, in 10 cases. LOH beta was not detected alone, but was always accompanied by alpha subunit or FSH beta. By the double staining method, alpha-subunit and FSH beta were not always colocalized in the same cells. Some cells were found to contain both alpha subunit and FH beta, but others contained either a subunit or FSH beta. Clinical characteristics of gonadotropin positive adenomas (38 cases) were studied in comparison with null cell adenomas (37 cases), which were negative for all anterior pituitary hormones. The former (male 27, female 11) ranged in age from 21-74 years old (man, 46.5 yr.), and the latter (male 16, female 21) from 28-68 yr (mean, 49.5 yr.). Gonadotropin positive adenomas tended to occur in middle-aged men. All 38 adenomas were macroadenomas, and 29 patients complained of visual failure. Clinical symptoms accompanied by hypersecretion of FSH was infrequent. Hypogonadism (ammenorrhea, galactorrhea, loss of libido) were obseved in 8 (9.6%) cases. Endocrinologically, the basal serum levels of gonadotropin were variable, although 10 (26.3%) patients showed abnormally high serum FSH concentrations. The response of serum FHS to LH-RH (luteinizing hormone-releasing hormone) was poor in 24 (63.2%) cases of gonadotropin positive adenomas and in 19 (51.4%) cases of null cell adenomas. Peak FSH values in LH-RH stimulation were greater than those of LH in 18 (52.9%) cases of gonadotropin positive adenomas and 10 (32.3%) cases of null cell adenomas. Our immunohistochemical and endocrinological studies suggest that the incidence of gonadotropin producing pituitary adenomas may be more frequent than hitherto suspected, and that a continuous transition may exist between gonadotrophin producing adenomas and null cell adenomas.


PMID: 1419353

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