Pituitary autoantibodies in patients with hypopituitarism and their relatives

Autoantibodies to human pituitary cytosol proteins were determined by immunoblotting in sera from patients with hypopituitarism and their relatives. Reactivity to an M(r) 49,000 protein was significantly more frequent in patients (6/21 (28%) P < 0.05) as well as in relatives (10/35 (28%) P < 0.02) compared with controls (3/44 (6.8%)). Autoantibodies to this particular protein have previously been detected in sera from 70% of patients with biopsy-proven lymphocytic hypophysitis. Unlike patients with biopsy-proven lymphocytic hypophysitis, none of the patients in this study presented with a suspected pituitary adenoma or showed an enlarged sella turcica. Cisternal herniation was seen in 6/21 patients and this may very well represent the end stage of lymphocytic hypophysitis. Since organ specific autoantibodies are frequent in patients with autoimmune endocrine disease as well as in their unaffected relatives, autoantibodies to this M(r) 49,000 pituitary cytosolic protein may represent markers for an immunological process affecting the pituitary gland.

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Concurrent lymphocytic hypophysitis and pituitary adenoma

Journal of Neurosurgery ◽

10.3171/jns.2006.105.2.309 ◽

2006 ◽

Vol 105 (2) ◽

pp. 309-314 ◽

Cited By ~ 16

Author(s):

Shaye I. Moskowitz ◽

Amir Hamrahian ◽

Richard A. Prayson ◽

Mercedes Pineyro ◽

Robert R. Lorenz ◽

...

Keyword(s):

Pituitary Adenoma ◽

Sella Turcica ◽

Mass Effect ◽

Lymphocytic Infiltration ◽

Lymphocytic Hypophysitis ◽

Null Cell ◽

History Of ◽

Concurrent Development ◽

Lymphocytic Adenohypophysitis ◽

Lesion Growth

✓Lymphocytic hypophysitis (LyH) is an uncommon intrasellar lesion characterized by lymphocytic infiltration of the adenohypophysis. Evidence suggests that the cause is autoimmune, and the symptoms are usually related to either a mass effect or endocrine dysfunction. Lymphocytic hypophysitis has been described rarely in the setting of other simultaneous pathological processes that involve the pituitary and sella turcica, and is postulated to arise from an intrinsic inflammatory response. The authors report the case of a 43-year-old woman who presented with a 2-month history of galactorrhea and pseudohyperprolactinemia secondary to a 10-mm lesion within an enlarged pituitary gland. She was nulliparous and had no contributory medical history. Serial neuroimaging performed over a 2-year period demonstrated lesion growth, and visual deficits had developed; together these warranted surgical intervention. A transsphenoidal resection was performed. Microscopic and immunohistopathological examinations revealed a nonsecreting pituitary adenoma with concurrent lymphocytic adenohypophysitis. This is the first documented case of LyH in the setting of a null-cell pituitary adenoma. The authors review the related literature and outline potential mechanisms for the concurrent development of LyH and a pituitary adenoma.

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Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/0004-2730000003363 ◽

2014 ◽

Vol 58 (6) ◽

pp. 661-665 ◽

Cited By ~ 5

Author(s):

Marcio Carlos Machado ◽

Sergio Kodaira ◽

Nina Rosa Castro Musolino

Keyword(s):

Differential Diagnosis ◽

Pituitary Adenoma ◽

Pituitary Gland ◽

Female Patient ◽

Pituitary Adenomas ◽

Sella Turcica ◽

Persistent Trigeminal Artery ◽

Trigeminal Artery ◽

Sellar Lesions ◽

History Of

Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas.

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Immunological and clinical aspects of lymphocytic hypophysitis

Clinical Science ◽

10.1042/cs20070051 ◽

2008 ◽

Vol 114 (6) ◽

pp. 413-421 ◽

Cited By ~ 29

Author(s):

Annamaria De Bellis ◽

Giuseppe Ruocco ◽

Marina Battaglia ◽

Marisa Conte ◽

Concetta Coronella ◽

...

Keyword(s):

Immune System ◽

Autoimmune Disease ◽

Pituitary Gland ◽

Lymphocytic Hypophysitis ◽

Clinical Aspects ◽

Antipituitary Antibodies ◽

Organ Specific ◽

Pituitary Enlargement

LYH (lymphocytic hypophysitis) is an autoimmune disease of the pituitary gland which can present with varying degrees of pituitary hormonal impairment and/or with symptoms related to pituitary enlargement. In this review, we provide an overview of the epidemiology, diagnosis, pathogenesis, treatment, and the role of organ-specific and antipituitary antibodies as potential markers of LYH. In addition, although the mechanisms underlying LYH are not completely understood, the role of prolactin, which plays an important part in maintaining immune system homoeostasis and is increased in the disease, is considered.

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The Ultrastructure of Lymphocytic Hypophysitis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100098824 ◽

1981 ◽

Vol 39 ◽

pp. 466-467

Author(s):

S.L. Asa ◽

K. Kovacs ◽

J. M. Bilbao ◽

R. G. Josse ◽

K. Kreines

Keyword(s):

Electron Microscopy ◽

Plasma Cells ◽

Secretory Granules ◽

Sella Turcica ◽

Uranyl Acetate ◽

Lymphocytic Hypophysitis ◽

Pituitary Cells ◽

Transmission Electron ◽

Ultrathin Sections ◽

Mass Lesions

Seven cases of lymphocytic hypophysitis in women have been reported previously in association with various degrees of hypopituitarism. We report two pregnant patients who presented with mass lesions of the sella turcica, clinically mimicking pituitary adenoma. However, pathologic examination revealed extensive infiltration of the anterior pituitary by lymphocytes and plasma cells with destruction of the gland. To our knowledge, the ultrastructural features of lymphocytic hypophysitis have not been studied so far.For transmission electron microscopy, tissue from surgical specimens was fixed in glutaraldehyde, postfixed in OsO4, dehydrated and embedded in epoxy-resin. Ultrathin sections were stained with uranyl acetate and lead citrate and examined with a Philips 300 electron microscope.Electron microscopy revealed adenohypophysial cells of all types exhibiting varying degrees of injury. In the areas of most dense inflammatory cell infiltration pituitary cells contained large lysosomal bodies fusing with secretory granules (Fig. 1), as well as increased numbers of swollen mitochondria, indicating oncocytic transformation (Fig. 2).

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THE EXTRACTION OF PROLACTIN FROM HUMAN PITUITARY GLANDS

Acta Endocrinologica ◽

10.1530/acta.0.0490001 ◽

1965 ◽

Vol 49 (1) ◽

pp. 1-16 ◽

Cited By ~ 12

Author(s):

M. Apostolakis

Keyword(s):

Growth Hormone ◽

Pituitary Gland ◽

List Type ◽

Distilled Water ◽

Hormone Activity ◽

Isoelectric Precipitation ◽

Human Pituitary ◽

Pituitary Glands ◽

Prolactin Content ◽

The Mean

ABSTRACT A method for the extraction of prolactin from human pituitary glands is described. It is based on acetone drying, distilled water extraction, acetone and isoelectric precipitation. Two main products are obtained: Fraction R8 with a mean prolactin activity of 12.2 IU/mg and fraction U8 with a mean prolactin activity of 8.6 IU/mg. The former fraction does not contain any significant gonadotrophin activity and the latter contains on an average 50 HMG U/mg. In both cases contamination with ACTH and MSH is minimal. The growth hormone activity of both these fractions is low. It is postulated that in man too, prolactin and growth hormone are two distinct hormones. A total of 1250 human pituitary glands have been processed by this method. The mean prolactin content per pituitary gland has been found to be 73 IU.

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Successful pregnancy after operation in an infertile woman caused by luteinizing hormone-secreting pituitary adenoma: case report and literature review

BMC Endocrine Disorders ◽

10.1186/s12902-020-00677-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yi Zhang ◽

Cheng Chen ◽

Min Lin ◽

Kan Deng ◽

Huijuan Zhu ◽

...

Keyword(s):

Case Report ◽

Pituitary Adenoma ◽

Literature Review ◽

Pituitary Adenomas ◽

Sella Turcica ◽

Infertile Woman ◽

Mass Treatment ◽

Successful Pregnancy ◽

Case Presentation ◽

Transsphenoidal Resection

Abstract Background Functional gonadotroph adenomas (FGAs) are rare adenomas that most commonly secrete FSH. However, solitary LH-secreting pituitary adenomas are unusual. Case presentation A 30-year-old woman with elevated LH and normal FSH presented with inability to conceive. An MRI revealed an enlarged sella turcica and an intrasellar mass. Treatment with transsphenoidal resection led to normalization of LH and estradiol, as well as successful pregnancy. And we reviewed 6 cases of LH-secreting pituitary adenomas from 1981 to 2020. Conclusions Our case is unique because of the LH-secreting pituitary adenoma without FSH hypersecretion. This case indicates that pituitary adenoma should be considered when other diseases causing infertility have been excluded.

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The combination of 13N-ammonia and 11C-methionine in differentiation of residual/recurrent pituitary adenoma from the pituitary gland remnant after trans-sphenoidal Adenomectomy

BMC Cancer ◽

10.1186/s12885-021-08574-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fangling Zhang ◽

Qiao He ◽

Ganhua Luo ◽

Yali Long ◽

Ruocheng Li ◽

...

Keyword(s):

Quantitative Analysis ◽

Pituitary Adenoma ◽

Pituitary Gland ◽

Gray Matter ◽

Standard Uptake Value ◽

Visual Evaluation ◽

Additional Surgery ◽

Pet Ct ◽

Histological Confirmation ◽

G Ratio

Abstract Background This study aimed to assess the clinical usefulness of 13N-ammonia and 11C- Methionine (MET) positron emission tomography (PET)/ computed tomography (CT) in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy. Methods Between June 2012 and December 2019, a total of 19 patients with a history of trans-sphenoidal adenomectomy before PET/CT scans and histological confirmation of RPA after additional surgery in our hospital were enrolled in this study. Images were interpreted by visual evaluation and semi-quantitative analysis. In semi-quantitative analysis, the maximum standard uptake value (SUVmax) of the target and gray matter was measured and the target uptake/gray matter uptake (T/G) ratio was calculated. Results The T/G ratios of 13N-ammonia were significantly higher in PGR than RPA (1.58 ± 0.69 vs 0.63 ± 1.37, P < 0.001), whereas the T/G ratios of 11C-MET were obviously lower in PGR than RPA (0.78 ± 0.35 vs 2.17 ± 0.54, P < 0.001). Using the canonical discriminant analysis, we calculated the predicted accuracy of RPA (100%), PGR (92.9%), and the overall predicted accuracy (96.43%). Conclusions The combination of 13N-ammonia and 11C-MET PET/CT is valuable in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy.

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The corticotrophic cells of the canine pituitary gland in pituitary-dependent hyperadrenocorticism

Journal of Endocrinology ◽

10.1677/joe.0.0960303 ◽

1983 ◽

Vol 96 (2) ◽

pp. 303-309 ◽

Cited By ~ 7

Author(s):

A. M. McNicol ◽

H. Thomson ◽

C. J. R. Stewart

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Pituitary Gland ◽

Cushing’S Disease ◽

Cushing's Disease ◽

Human Pituitary ◽

Human Pituitary Gland ◽

Single Entity ◽

Pituitary Glands ◽

Corticotrophic Cells

The distribution of specifically stained corticotrophic cells has been studied in the pituitary glands of 11 dogs with pituitary-dependent hyperadrenocorticism. The results suggest that the disease is not a single entity, and that some cases are caused by primary abnormality of the pituitary gland whereas others appear to be the result of dysfunction of the hypothalamus or central nervous system. The patterns correspond closely to those demonstrated in the human pituitary gland in Cushing's disease, and confirm that the canine disease is a useful model for the study of the pathogenesis of the variants of the condition.

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