Growth hormone-secreting adenomas: pathology and cell biology

Abstract

<jats:p>The majority of patients with acromegaly harbor a functioning growth hormone (GH) pituitary adenoma. Growth hormone–secreting adenomas correspond to about 20% of all pituitary adenomas. From the histopathological point of view, a variety of adenomas may present with clinical signs and symptoms of GH hypersecretion including pure GH cell adenomas (densely and sparsely granulated GH adenomas), mixed GH and prolactin cell adenomas, and monomorphous adenomas with primitive cells able to secrete GH and prolactin including the acidophilic stem cell adenoma and the mammosomatotroph cell adenoma. In this article, the author reviews the main pathological features of the GH-secreting adenomas and some of the molecular genetics mechanisms involved in their pathogenesis.</jats:p>

Granulation pattern, but not GSP or GHR mutation, is associated with clinical characteristics in somatostatin-naïve patients with somatotroph adenomas

“…Cells often show nuclear pleomorphism with weak, focal GH immunoreactivity and do not resemble normal somatotrophs. Electron microscopy reveals small uniform granules of GH, aligned along the plasma membrane (2,3,4,5). The most distinctive feature of SG adenomas is the presence of fibrous bodies.…”

“…There is strong, diffuse cytoplasmic GH immunoreactivity. Electron microscopy reveals a well-developed rough endoplasmic reticulum, a prominent Golgi complex and numerous large (300-600 nm) secretory granules containing GH, distributed throughout the cytosol (2,3,4,5).…”

Risperidone-induced acromegaly: a case report

“…According to Gianfrancesco and colleagues (as reported in the pharmacovigilance study by Szarfman et al [2006]), compared with other antipsychotics, risperidone-treated patients were found to have a higher risk of the occurrence of pituitary tumors [Gianfrancesco et al 2009]. This suggests that, when a high level of prolactin is detected in patients treated with risperidone, it is worth doing pituitary tumor research using brain imaging studies, because these tumors are usually small, benign and remain endocrinologically silent [Lopes, 2010]. In a study of Kurt and colleagues, it was shown that even the use of low-dose risperidone causes more prolactin increase compared with haloperidol [Kurt et al 2008].…”

“…IGF-1 levels should be evaluated taking age and gender into account. Acromegalic patients in general complain of coarsening of the face, growth in the extremities, headache, fatigue, excessive sweating, and gonadal dysfunction [Lopes, 2010]. High GH and IGF-1 levels lead a clinical table containing arthritis, facial changes, prognathism, and glucose intolerance.…”

Two Autopsy Cases Assessing the Association of Rare Tumors Adjacent to the Sella turcica with Cause of Death and a Review of the Literature

“…As for functional adenomas, about 30% of all pituitary adenomas are prolactin-producting tumors, which occur approximately eight times more frequently in females than in males [21]. In addition, about 20% of pituitary adenomas are growth hormone-producing tumors, while other types of pituitary tumors are reported to be extremely rare [22]. The pituitary gland adenoma seen in Case 2 is classified as a plurihormonal adenoma, an adenoma producing multiple hormones, based on the Kovacs classification and has an incidence rate of less than 1% [23].…”