Cushing's Disease Associated with an lntrasellar Gangliocytoma Producing Corticotrophin-Releasing Factor
- SYLVIA L. ASA, M.D.;
- KALMAN KOVACS, M.D., Ph.D.;
- GEORGE T. TINDALL, M.D.;
- DANIEL L. BARROW, M.D.;
- EVA HORVATH, Ph.D.; and
- PAUL VECSEI, M.D.
Excerpt
A 58-year-old woman had Cushing's disease with elevated plasma adrenocorticotrophin and an intrasellar tumor. Light microscopy showed that the tumor was a gangliocytoma containing immunoreactive corticotrophinreleasing factor accompanied by pituitary corticotroph hyperplasia. Ultrastructural examination identified an intimate association and desmosomal attachments between interdigitating cell processes of neurons and corticotrophs. It is suggested that Cushing's disease was due to the effect of corticotrophin-releasing factor on corticotrophs; this case represents a syndrome supporting the concept that, in some patients, Cushing's disease may have a hypothalamic origin.
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgments
ACKNOWLEDGMENTS: The authors thank the following sources of antisera used in immunohistochemical studies: Dr. H. Friesen, University of Manitoba, Winnipeg, Manitoba, Canada (prolactin, lot AR-1-7); Dr. F.A. Laszlo, University of Szeged, Szeged, Hungary (vasopressin); Dr. A.F. Parlow, the National Pituitary Hormone Distribution Program, National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland (growth hormone, lot AFP-1 [779219]; adrenocorticotrophin, lot AFP-1732; beta-follicle stimulating hormone, lot AFP-3710194; beta-luteinizing hormone, lot AFP-54372); Dr. P. Petrusz, University of North Carolina, Chapel Hill, North Carolina (beta-endorphin, lot 222); Dr. S. Reichlin, Tufts University, Boston, Massachusetts (somatostatin, lot 655); Dr. W. Vale, The Salk Institute, San Diego, California (growth hormone-releasing factor 40, batch G60); Bio-Rad Laboratories, Richmond, California (betathyrotrophin, lot R22 [6/30/78]); Dako Corporation, Santa Barbara, California (glial fibrillary acidic protein, lot 022; insulin, lot 022; gastrin, lot 062; glucagon, lot 013-P); Miles Laboratory, Elkhard, Indiana (gonadotrophin-releasing hormone, lot uZ6). The authors also thank Mrs. Nancy Ryan and Mrs. Sandra Briggs for their technical assistance, and Mrs. Wanda Wlodarski for secretarial help. Assistance with absorption studies of the antiserum directed against corticotrophin-releasing factor was kindly provided by Dr. D. Healy, and Dr. M. Printz, Division of Pharmacology, Department of Medicine, University of California at San Diego, La Jolla, California. The authors also thank Dr. W. Singer for invaluable assistance in manuscript preparation.
Article and Author Information
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▸From the Department of Pathology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; the Department of Surgery, Division of Neurosurgery, Emory University, Atlanta, Georgia; and the Department of Pharmacology, University of Heidelberg, Heidelberg, Federal Republic of Germany.
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Grant support: in part by grant MA-6349 from the Medical Research Council of Canada, and the Lyndhurst Foundation, Chattanooga, Tennessee. Dr. Asa is a Research Fellow of the Medical Research Council of Canada.
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▸Requests for reprints should be addressed to: Sylvia L. Asa, M.D.; Department of Pathology, St. Michael's Hospital, 30 Bond Street; Toronto, Ontario M5B 1W8 Canada.
- © 1984 American College of Physicians
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