Human pituitary gonadotropic adenoma; histological, immunocytochemical, and ultrastructural and hormonal studies in eight cases

Abstract

Among 230 surgically removed pituitary adenomas, eight tumours showing immunostaining gonadotropic cells and elevated intratumours gonadotropin concentrations have been detected (frequency: 3.5 per cent.). By light microscopy the tumours were composed of agranular cells and generally PAS negative cytoplasm. The immunofluorescence technique revealed the presence of immunoreactive FSH (beta-subunit) alone in two cases, of both FSH and LH in six cases with immunoreactive beta endorphin in two of them. By electron microscopy, the cells contained an often dilated moderately or well developed rough endoplasmic reticulum, secretory granules measuring 150 nm to 200 nm which varied in electron density, and numerous microtubules. Basal plasma FSH and LH levels were simultaneously elevated in two cases; FSH levels alone were elevated in two cases; in three cases, both FSH and LH plasma values were normal. FSH and LH intratumour concentrations were simultaneously elevated in five cases; FSH alone was elevated in two cases. In all cases, the concentrations of the other hormones were negligible, except in two cases where beta endorphin concentration was elevated. The comparison of the immunocytochemical findings, the hormonal plasma levels and intratumour concentrations showed a good relationship between the immunoreactivity of the tumour and the intratumour RIA. The gonadotropic adenoma is uncommon but not rare. Its diagnosis is possible if immunocytochemical techniques are applied.