高ACTH血症を示したsilent corticotroph cell adenomaの1例

概要

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Adrenocorticotropic hormone (ACTH) -secreting pituitary adenomas show hypercortisolism and several clinical symptoms of Cushing's syndrome. Some pituitary adenomas, however, contain immunoreactive ACTH (ir-ACTH) without hypercortisolism or clinical symptoms of Cushing's syndrome. This was defined as silent corticotroph cell adenoma by Kovacs et al. in 1978. A case of silent corticotroph cell adenoma with high levels of plasma ir-ACTH was experienced. A 34-year-old male was admitted because of visual acuity and visual field disturbances. He was obese, but showed no clinical symptoms of Cushing's disease. Plain computed tomography scan showed a large irregular-shaped mass extending from the sellar region to the third ventricle, which was enhanced homogeneously with contrast medium. Endocrinological investigations showed plasma ir-ACTH in high levels and serum cortisol in the upper limits of the normal range. The tumor was a chromophobic pituitary adenoma and ACTH immunoreactivity was demonstrated by immunocytochemical staining. Gel chromatography demonstrated a peak of ACTH immunoreactivity alone, which eluted at an earlier position than 1-39 ACTH.
日本脳神経外科学会の論文
1987-08-15