Skip to main content
SpringerLink
Log in

Two cases of pituitary Crooke’s cell adenoma without Cushing’s disease: A histologic, immunocytochemical, electron microscopic andin situ hybridization study

  • Clinical Research
  • Published:
Endocrine Pathology Aims and scope Submit manuscript

Abstract

Presented herein are the morphologic features of two cases of pituitary Crooke’s cell adenoma unassociated with Cushing’s disease. Both were removed surgically, one from a 62-yr-old woman and the other from a 37-yr-old man. Crooke’s cell adenomas are rare. All previously published cases were associated with clinical and laboratory evidence of Cushing’s disease. The two cases presented here are the first that were unaccompanied by adrenocorticotropin (ACTH)-cortisol excess. Crooke’s cell adenomas are composed of abnormal corticotrophs containing periodic acid-Schiff-(PAS) negative, ACTH-immunonegative, and keratin-immunoreactive cytoplasmic microfilaments filling large areas of the cytoplasm and displacing other organelles. Adenomatous Crooke’s cells express proopiomelanocortin (POMC) mRNA. The question of whether the absence of ACTH-cortisol hypersecretion in our two cases is mediated via functioning glucocorticoid receptors in the adenoma cells or whether other mechanisms are involved remains to be elucidated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Felix IA, Horvath E, Kovacs K. Massive Crooke’s hyalinization in corticotroph cell adenoma of the human pituitary. A histological, immunocytochemical, and electron microscopic study of three cases. Acta Neurochir 58:235–243, 1981.

    Article  CAS  Google Scholar 

  2. Horvath E, Kovacs K, Josse R. Pituitary corticotroph cell adenoma with marked abundance of microfilaments. Ultrastruct Pathol 5:249–255, 1983.

    PubMed  CAS  Google Scholar 

  3. Horvath E, Kovacs K. The adenohypophysis. In: Kovacs K, Asa SL, eds. Functional Endocrine Pathology, 2nd ed. Boston: Blackwell, 1998; 247–281.

    Google Scholar 

  4. Horvath E, Kovacs K. Ultrastructural diagnosis of human pituitary adenomas. Micr Res Techn 20:107–135, 1992.

    Article  CAS  Google Scholar 

  5. Kovacs K, Scheithauer BW, Horvath E, Lloyd RV. The World Health Organization classification of adenohypophysial neoplasms. A proposed five-tier scheme. Cancer 78:502–510, 1996.

    Article  PubMed  CAS  Google Scholar 

  6. Kovacs K. The pathology of Cushing’s disease. J Steroid Biochem Mol Biol 45:179–182, 1993.

    Article  PubMed  CAS  Google Scholar 

  7. Horvath E, Scheithauer BW, Kovacs K, Lloyd RV. Regional neuropathology: hypothalamus and pituitary. In: Graham DI, Lantos PL, eds. Greenfield’s Neuropathology, 6th ed. London: Arnold, 1997; 1007–1094.

    Google Scholar 

  8. Crooke AC. A change in the basophil cells of the pituitary gland common to conditions which exhibit the syndrome attributed to basophil adenoma. J Pathol Bacteriol 41:339–349, 1935.

    Article  Google Scholar 

  9. Neuman PE, Horoupian DS, Goldman JE, Hess MA. Cytoplasmic filaments of Crooke’s hyaline change belong to the cytokeratin class. An immunocytochemical and ultrastructural study. Am J Pathol 116:214–222, 1984.

    Google Scholar 

  10. Kovacs K, Horvath E. Tumors of the pituitary gland. Atlas of Tumor Pathology, 2nd series, Armed Forces Institute of Pathology, Bethesda: fascicle 21. 1986.

    Google Scholar 

  11. Kovacs K, Stefaneanu L, Ezzat S, Smyth HS. Prolactin-producing pituitary adenoma in a male-to-female transsexual patient with protracted estrogen administration. A morphologic study. Arch Pathol Lab Med 118:562–565, 1994.

    PubMed  CAS  Google Scholar 

  12. Kovacs K, Giannini C, Scheithauer BW, Stefaneanu L, Lloyd RV, Horvath E. Pituitary changes in ataxia-telangiectasia syndrome: an immunocytochemical, in situ hybridization, and DNA cytometric study of three cases. Endocr Pathol 8:195–203, 1997.

    PubMed  CAS  Google Scholar 

  13. Kovacs K, Lloyd RV, Horvath E, Asa SL, Stefaneanu L, Killinger DW. Silent somatotroph adenomas of the human pituitary. A morphologic study of three cases including immunocytochemistry, electron microscopy, in vitro examination, and in situ hybridization. Am J Pathol 134:345–353, 1989.

    PubMed  CAS  Google Scholar 

  14. Kovacs K, Stefaneanu L, Horvath E, Lloyd RV, Lancranjan I, Buchfelder M, et al. Effect of dopamine agonist medication on prolactin producing pituitary adenomas. A morphological study including immunocytochemistry, electron microscopy and in situ hybridization. Virchows Arch Pathol Anat 418:439–446, 1991.

    Article  CAS  Google Scholar 

  15. Stefaneanu L, Kovacs K, Horvath E, Lloyd RV. In situ hybridization study of proopiomelanocortin (POMC) gene expression in human pituitary corticotrophs and their adenomas. Virchows Arch Pathol Anat 419:107–113, 1991.

    Article  CAS  Google Scholar 

  16. Kovacs K, Stefaneanu L, Horvath E, Buchfelder M, Fahlbusch R, Becker W. Prolactin-producing pituitary tumor: resistance to dopamine agonist therapy. J Neurosurg 82:886–890, 1995.

    Article  PubMed  CAS  Google Scholar 

  17. Orth DN. Cushing’s Syndrome. N Engl J Med 332:791–803, 1995.

    Article  PubMed  CAS  Google Scholar 

  18. Dickstein G, Spindel A, Shechner C, Adawi F, Gutman H. Spontaneous remission in Cushing’s disease. Arch Intern Med 151:185–189, 1991.

    Article  PubMed  CAS  Google Scholar 

  19. Ishibashi M, Shimada K, Abe K, Furue H, Yamaji T. Spontaneous remission in Cushing’s disease. Arch Intern Med 153:251–255, 1993.

    Article  PubMed  CAS  Google Scholar 

  20. Dickstein G, Arad E, Shechner C. Late complications in remission from Cushing disease. Recurrence of tumor with reinfarction or transformation into a silent adenoma. Arch Intern Med 157:2377–2380, 1997.

    Article  PubMed  CAS  Google Scholar 

  21. Bamberger CM, Schulte HM, Chrousos GP. Molecular determinants of glucocorticoid receptor function and tissue sensitivity to glucocorticoids. Endocr Rev 17:245–261, 1996.

    Article  PubMed  CAS  Google Scholar 

  22. Clark AJL. Receptor hypersensitivity: a new phenomenon? Clin Endocrin 48:135–136, 1998.

    Article  CAS  Google Scholar 

  23. Horvath E, Kovacs K, Killinger DW, Smyth HS, Platts ME, Singer W. Silent corticotropic adenomas of the human pituitary gland: a histologic, immunocytologic and ultrastructural study. Am J Pathol 98:617–638, 1980.

    PubMed  CAS  Google Scholar 

  24. Horvath E, Kovacs K, Lloyd RV. Pars intermedia of the human pituitary revisited: morphologic aspects and frequency of hyperplasia of POMC-peptide immunoreactive cell. Endocrin Pathol (in press).

  25. Kovacs K, Horvath E, Stratmann I, Ezrin C. Cytoplasmic microfilaments in the anterior lobe of the human pituitary gland. Acta Anat 87:414–426, 1974.

    Article  PubMed  CAS  Google Scholar 

  26. Robert F, Pelletier G, Hardy J. Pituitary adenomas in Cushing’s disease. A histologic, ultrastructural and immunocytochemical study. Arch Pathol Lab Med 102:448–455, 1978.

    PubMed  CAS  Google Scholar 

  27. Burgess TL, Kelly RB. Constitutive and regulated secretion of proteins. Ann Rev Cell Biol 3:243–293, 1987.

    PubMed  CAS  Google Scholar 

  28. Aunis D, Bader MF. The cytoskeleton as a barrier to exocytosis in secretory cells. J Exp Biol 139:253–266, 1988.

    PubMed  CAS  Google Scholar 

  29. Ravindra R, Grosvenor CE. Involvement of cytoskeleton in polypeptide hormone secretion from the anterior pituitary lobe: a review. Mol Cell Endocrinol 71:165–176, 1990.

    Article  PubMed  CAS  Google Scholar 

  30. Castellino F, Heuser J, Marchetti S, Bruno B, Luini A. Glucocorticoid stabilization of actin filaments: a possible mechanism for inhibition of corticotropin release. Proc Natl Acad Sci USA 89:3775–3779, 1992.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Laboratory Medicine, Endocrinology and Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

    Kalman Kovacs, Eva Horvath, Lucia Stefaneanu, Juan M. Bilbao, William Singer & Paul Muller

  2. Department of Laboratory Medicine, Mayo Clinic, Rochester, MN

    Bernd W. Scheithauer

Authors
  1. Kalman Kovacs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eva Horvath
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lucia Stefaneanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juan M. Bilbao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. William Singer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul Muller
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bernd W. Scheithauer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kovacs, K., Horvath, E., Stefaneanu, L. et al. Two cases of pituitary Crooke’s cell adenoma without Cushing’s disease: A histologic, immunocytochemical, electron microscopic andin situ hybridization study. Endocr Pathol 10, 65–72 (1999). https://doi.org/10.1007/BF02738817

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02738817

Key words

Search

Navigation