ID 111461
Title Alternative
GH RESPONSES AND PATHOLOGY IN ACROMEGALY
Author
Bando, Hiroshi University of Tokushima KAKEN Search Researchers
Ohshima, Tsutomu University of Tokushima
Zhang, Chen-Yu University of Tokushima
Yamasaki, Ryuichi University of Tokushima
Matsumoto, Keizo University of Tokushima
Saito, Shiro University of Tokushima
Keywords
Acromegaly
Cytokeratin
Immunohistochemistry
Growth hormone (GH)
Somatostatin
Content Type
Journal Article
Description
Plasma growth hormone (GH) responses to various stimuli were examined in 21 patients with GH-producing pituitary adenomas, classified into three types by the immunohistochemistry of cytokeratin and the glycoprotein hormone α-subunit distribution. Seven type 1 adenomas were exclusively composed of cells in which the cytokeratin formed a dot-like pattern; they were chromophobic to hematoxylin and eosin (H & E), occasionally positive for GH, and almost completely negative for the α-subunit. Thirteen type 2 adenomas were composed of cells with cytokeratin that had a perinuclear distribution; they were eosinophilic to H & E, and diffusely positive for both GH and the α-subunit. One patient had a type 3 adenoma which had a mixed pattern of intracellular cytokeratin distribution and was chromophobic and eosinophilic to H & E. Clinically, type 1 is characterized by earlier onset, larger tumor size, and more frequent aggressive extension. Paradoxical GH responses to TRH and OGTT were seen in 1 of 6 patients (16.7%) of type 1 and 8 of 9 patients (88.9%) of type 2, and 0% of type 1 and 62.5% of type 2, respectively. Type 2 cases showed higher plasma GH response to GH-releasing hormone, and a tendency to greater suppression of plasma GH by bromocriptine compared with type 1. Octreotide acetate administration revealed that the nadir/basal ratio of plasma GH levels was 42.9±6.6% in type 1 and 13.5±5.8% in type 2. These results suggest that there is a pathophysiological difference between these two distinct types of GH-producing pituitary adenomas.
Journal Title
Endocrinologia Japonica
ISSN
21856370
00137219
NCID
AA00635052
Publisher
The Japan Endocrine Society
Volume
39
Issue
4
Start Page
355
End Page
363
Published Date
1992
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
Oral Sciences