Summary
A 29-year old giantess with growth hormone excess and hyperprolactinemia underwent transsphenoidal surgery to remove her pituitary tumor. Electron microscopy revealed a mammosomatotroph adenoma composed of one cell type. Immunoelectron microscopy, using the immunogold technique, demonstrated predominantly growth hormone or prolactin or a varying mixture of both growth hormone and prolactin in the adenoma cells. The presence of growth hormone and prolactin was found not only in the cytoplasm of the same adenoma cells but also in the same secretory granules. In the nontumorous adenohypophysis, somatotrophs and lactotrophs showed ultrastructural signs of hyperactivity. This finding is in contrast with the presence of suppressed somatotrophs and lactotrophs seen in nontumorous portions of adult pituitaries harboring growth hormone or prolactin-secreting adenomas. Our morphological study reinforces the view that growth hormone-producing pituitary tumors, originating in childhood, are different from those of the adult gland.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bendayan M (1982) Double immunocytochemical labeling applying the protein A-gold technique. J. Histochem Cytochem 30:81–85
Bendayan M (1984) Protein A-gold electron microscopic immunocytochemistry: methods, application and limitation. J Electron Microsc Tech 1:243–270
Corenblum B, Sirek AMT, Horvath E, Kovacs K, Ezrin C (1976) Human mixed somatotrophic and lactotrophic pituitary adenomas. J Clin Endocrinol Metab 42:857–863
Cushing H, Davidoff LM (1927) The pathological finding in four autopsied cases of acromegaly with a discussion of their significance. Rockefeller Inst Med Res Monograph 22:1–131
DeLellis RA, Tischler AS, Wolfe HJ (1984) Multidirectional differentiation in neuroendocrine neoplasms. J Histochem Cytochem 32:889–904
Espiner EA, Carter TAH, Abbott GD, Wrightson P (1981) Pituitary gigantism in a 32-month-old girl: endocrine study and successful response to hypophysectomy. J Endocrinol Invest 4:445–450
Favre L, Rogers LM, Ludecke DK, Cobb CA, Rabin D (1979) Gigantism associated with a pituitary tumor secreting growth hormone and prolactin and cured by transsphenoidal hypophysectomy. Acta Endocrinol 91:193–200
Guyda H, Robert F, Colle E, Hardy J (1973) Histologic, ultrastructural, and hormonal characterization of the pituitary tumor secreting both hGH and prolactin. J Clin Endocrinol Metab 36:531–543
Haigler ED Jr, Hershmann JM, Meador CK (1973) Pituitary gigantism. Arch Intern Med 132:588–594
Halmi NS (1982) Occurrence of both growth hormone and prolactin immunoreactive material in the cell of human somatotrophic pituitary adenoma containing mammosomatotrophic elements. Virchows Arch [A] 398:19–31
Heppner GH (1984) Tumor heterogeneity. Cancer Res 44: 2259–2265
Horvath E, Kovacs K (1986) Pathology of prolactin cell adenomas of the human pituitary. Semin Diagn Pathol 3:4–17
Horvath E, Kovacs K, Singer W, Smyth HS, Killinger DW, Ezrin C, Weiss MW (1981) Acidophil stem cell adenoma of the pituitary: a clinico-pathologic analysis of 15 cases. Cancer 47:761–771
Horvath E, Kovacs K, Killinger DW, Smyth H, Weiss MH, Ezrin C (1983a) Mammosomatotroph cell adenoma of the human pituitary: a morphologic entity. Virchows Arch [A] 398:277–289
Horvath E, Kovacs K, Scheithauer BW, Randall RV, Laws ER Jr, Thorner MO, Tindall GT, Barrow DL (1983b) Pituitary adenomas producing growth hormone, prolactin, and one or more glycoprotein hormones: a histologic, immunohistochemical, and ultrastructural study of four surgically-removed tumors. Ultrastruct Pathol 5:171–183
Horvath E, Scheithauer BW, Kovacs K (1986) Morphologic aspects of growth hormone-producing pituitary adenomas with emphasis on novel concepts. In: Tolis G, Lüdecke DK (eds). Growth hormone. Raven Press, New York (in press)
Hsu SM, Raine L, Fanger H (1981a) A comparative study of the peroxidase-antiperoxidase method and an avidin-biotin complex method for studying polypeptide hormones with radioimmunoassay antibodies. Am J Clin Pathol 75:734–738
Hsu SM, Raine L, Fanger H (1981b) The use of antiavidin antibody and avidin-biotin-peroxidase complex in immunoperoxidase technics. Am J Clin Pathol 75:816–821
Ishikawa H, Nogami H, Kamio M, Suzuki T (1983) Single secretory granules contain both GH and prolactin in pituitary mixed type of adenoma. Virchows Arch [A] 399:221–226
Jialal I, Nathoo BC, Joubert SM, Asmal AC, Pillay NL (1982) The clinical presentation and biochemical diagnosis of acromegaly and gigantism. S Afr Med J 61:617–620
Kanie N, Kageyama N, Kuwayama A, Nakane T, Watanabe M, Kawaoi A (1983) Pituitary adenomas in acromegalic patients: an immunohistochemical and endocrinological study with special reference to prolactin-secreting adenoma. J Clin Endocrinol Metab 57:1093–1101
Kovacs K, Horvath E (1986a) Pathology of growth hormone-producing tumors of the human pituitary. Semin Diagn Pathol 3:18–33
Kovacs K, Horvath E (1986b) Tumors of the pituitary. In: Hartmann WH (ed) Atlas in tumor pathology, 2nd series, Fascicle XXI. Armed Forces Institute of Pathology, Washington DC
Kovacs K, Horvath E, Thorner MO, Rogol D (1984) Mammosomatotroph hyperplasia associated with acromegaly and hyperprolactinemia in a patient with McCune-Albright syndrome. Virchows Arch [A] 403:77–86
McComb DJ, Kovacs K, Beri J, Zak F (1984) Pituitary adenomas in old Sprague-Dawley rats: a histological, ultrastructural, and immunocytochemical study. J Natl Cancer Inst 73:1143–1166
Peillon F, Philippon J, Brandi AM, Fohanno D, Laplane D, Dubois MP, Decourt J (1979) Prolactin-secreting pituitary adenoma in a man with gigantism: a case report. Acta Endocrinol 92:627–639
Polychronakos C, Tsoukas G, Ducharme JR, Letarte J, Collu R (1982) Gigantism and hyperprolactinemia in polyostotic fibrous dysplasia (McCune-Albright syndrome). J Endocrinol Invest 5:323–326
Robert F (1973) L'adénome hypophysaire dans l'acromégalie-gigantisme. Étude macroscopique, histologique et ultrastructurale. Neurochirurgie 19:[Suppl] 2:117–184
Roth T, Bendayan M, Orci L (1978) Ultrastructural localization of intracellular antigens by the use of protein A-gold complex. J Histochem Cytochem 26:1074–1081
Saeger W (1977) Die Morphologie der paraadenomatösen Adenohypophyse. Ein Beitrag zur Pathogenese der Hypophysenadenome. Virchows Arch [A] 372:299–314
Scheithauer BW, Kovacs K, Randall RV, Horvath E, Laws ER (1986) Pathology of excessive production of growth hormone. Clin Endocrinol Metab (in press)
Thorner MO, Perryman RL, Cronin MJ, Rogol AD, Draznin M, Johanson A, Vale W, Horvath E, Kovacs K (1982) Somatotroph hyperplasia. Successful treatment of acromegaly by removal of a pancreatic islet tumor secreting a growth hormone-releasing factor. J Clin Invest 70:965–977
Whitehead EM, Shalet SM, Davies D, Enoch BA, Price DA, Beardwell CG (1982) Pituitary gigantism: a disabling condition. Clin Endocrinol 17:271–277
Zampieri P, Scanarini M, Sicolo N, Andrioli G, Mingrino S (1983) The acromegaly-gigantism syndrome: report of four cases treated surgically. Surg Neurol 20:498–503
Author information
Authors and Affiliations
Additional information
Supported in part by Grant MT-6349 of the Medical Research Council of Canada
Rights and permissions
About this article
Cite this article
Felix, I.A., Horvath, E., Kovacs, K. et al. Mammosomatotroph adenoma of the pituitary associated with gigantism and hyperprolactinemia. A morphological study including immunoelectron microscopy. Acta Neuropathol 71, 76–82 (1986). https://doi.org/10.1007/BF00687965
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00687965