Pituitary Pathology in Erdheim–Chester Disease
| Autor: | Victor Fornasier, Kalman Kovacs, Juan M. Bilbao, Eva Horvath |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Anterior hypopituitarism Erdheim-Chester Disease endocrine system Pathology medicine.medical_specialty Endocrinology Diabetes and Metabolism Pathology and Forensic Medicine Prolactin cell Fatal Outcome Endocrinology Anterior pituitary Internal medicine medicine Humans Sella Turcica business.industry General Medicine Hyperplasia medicine.disease Prolactin medicine.anatomical_structure Hypothalamus Pituitary Gland Erdheim–Chester disease Diabetes insipidus Female business Diabetes Insipidus hormones hormone substitutes and hormone antagonists |
| Zdroj: | Endocrine Pathology. 15:159-166 |
| ISSN: | 1046-3976 |
| DOI: | 10.1385/ep:15:2:159 |
| Popis: | Pituitary morphologic changes in patients with Erdheim-Chester disease have not been described in detail. We report here the histologic and immunohistochemical findings in the autopsy obtained pituitary of a 35-yr-old woman with extensively disseminated Erdheim-Chester disease. The posterior lobe was completely replaced by xanthogranulomatous infiltrates, providing an explanation for the patient's diabetes insipidus. The anterior lobe was intact and immunohistochemistry demonstrated expression of GH, TSH, FSH, LH, and alpha subunit within the normal range. A clinically observed decrease of anterior pituitary function was interpreted as hypothalamic in origin due to massive destruction of the hypophysial stalk and compression of the hypothalamus. Prolactin immunoreactive cells were numerous, consistent with the view that prolactin cell hyperplasia resulted from the loss of hypothalamic dopaminergic inhibition. Massive Crooke's hyalinization in the ACTH-producing cells was considered unrelated to Erdheim-Chester disease and was the consequence of treatment with pharmacologic doses of glucocorticoid hormones. It can be concluded that prolactin cell hyperplasia may be the only finding in the adenohypophysis of patients with disseminated Erdheim-Chester disease. It appears that in our patient the clinically apparent anterior hypopituitarism was not due to the lack of storage but rather to insufficient release of adenohypophysial hormones caused by the defect in hypothalamic regulation. |
| Databáze: | OpenAIRE |
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