PubMed Health⌕ Search

Biomedical subjects

Ricardo V. Lloyd

Publications and source records attributed to Ricardo V. Lloyd.

17 recordsLinked to original sources

Insulin and Glucagon mRNA Expression and Prohormone Convertase Immunoreactivity in Normal and Neoplastic Pancreatic Endocrine Tissue.

Prohormone convertase (PC) 1/3 and PC2 are neuroendocrine-specific enzymes that convert prohormones to active hormones. To learn more about the role of these PCs in normal and neoplastic islet cells, we analyzed a series of pancreatic endocrine tumors to determine the role of PC1/3 and PC2 in islet cell hormone processing. In situ hybridization with insulin and glucagon probes and immunostaining with antibodies to PC1/3 and PC2 were done with 6 normal pancreases, 33 insulinomas, and 7 glucagonomas. The intensity of the reactions was graded from 0 to 3+. Normal islets stained strongly for both proinsulin and proglucagon mRNAs. Insulinomas and glucagonomas had readily detected hormone mRNAs for proinsulin and proglucagon, respectively. Normal pancreatic insulin cells stained weakly for PC1/3 (1+) and PC2 (1-2+), and glucagon cells stained weakly for PC1/3 (1-2+) and strongly for PC2 (2-3+). Both insulinomas and glucagonomas stained strongly for PC2 (2-3+) with less intense staining for PC1 (1-2+). These results indicate that PC2 is more highly expressed in insulin- and glucagon-producing pancreatic islet cell tumors and that there is increased expression of PC2 in insulinomas compared to normal insulin-producing cells.

Journal Article↗

Prognostic Significance of p27, Ki-67, and Topoisomerase lla Expression in Clinically Nonfunctioning Pancreatic Endocrine Tumors.

Nonfunctioning islet cell tumors or pancreatic endocrine tumors are the most common type of malignant islet cell tumor. Although previously detected usually at an advanced stage because of mass effect, the early detection rate of small localized disease has been increasing. To date it has been difficult to predict the clinical behavior in localized regional nonfunctioning tumors. To investigate potential markers predicting malignancy and poor prognosis in nonfunctioning pancreatic endocrine tumors, we analyzed the expression of Ki-67, topoisomerase Ila (Topolla), and p27, as well as a variety of clinicopathologic parameters in 76 cases of nonfunctioning islet cell tumors (23 benign cases and 53 malignant cases). Ki-67, Topolla. and p27 labeling indices were significantly different between benign and malignant tumors. Expression of Ki-67, Topolla, and p27 were associated with survival in patients with a malignant tumor in a univariate setting. However, only p27 and Topolla were jointly associated with survival in multivariate analysis. Immunohistochemical staining for p27, Topolla, and Ki-67 can be helpful in the diagnosis of nonfunctioning pancreatic endocrine tumor. Analysis of p27 and Topolla may also have potential utility as prognostic factors for malignant tumors.

Journal Article↗

Vascular Endothelial Growth Factor (VEGF) Expression in Human Pituitary Adenomas and Carcinomas.

Vascular endothelial growth factor (VEGF) is a key mediator of endothelial cell proliferation, angiogenesis, and vascular permeability. Little is known about its expression in human pituitary adenomas. We examined 148 human pituitary adenomas for VEGF protein expression by immunohistochemistry. The strongest immunoreactivity was present in GH adenomas, corticotroph, silent corticotroph. silent subtype 3, and nononcocytic null cell adenomas. GH adenomas treated with octreotide stained less intensely than did untreated tumors. Relatively weak staining was present in PRL, gonadotroph, thyrotroph, and oncocytic null cell adenomas in the same sections showed evidence of down-regulation of VEGE protein expression in adenomas. Pituitary carcinomas usually had stronger staining than adenomas. In situ hybridization studies with oligonucleotide probes showed positive staining in all groups with stronger staining in GH, ACTH, TSH, and gonadotroph adenomas and in pituitary carcinomas. These results indicate that VEGF expression is more prominent in certain adenoma subtypes, that decreased expression occurs in adenomas as compared to nontumorous pituitary and that carcinomas show increased VEGF expression relative to adenomas suggesting up-regulation of VEGF during pituitary tumor progression.

Journal Article↗

Neoplasms Causing Nonhyperinsulinemic Hypoglycemia.

Non-islet cell tumor hypoglycemia (NICTH) is uncommon. Many of the tumors associated with NICTH are mesenchymal tumors, although carcinomas are also involved in some cases. High serum levels of insulin-like growth factor II (IGF-II) have been associated with NICTH. Analysis of 4 pituitary tumors, 2 adrenocortical tumors, 42 solitary fibrous tumors, and 23 other mesenchymal tumors for IGF-II protein and mRNA showed that most mesenchymal tumors expressed IGF-II protein and mRNA, although only 4 of 48 patients had associated hypoglycemia. Tumor size was related to IGF-II production. Tumors less than 5 cm were usually negative for IGF-II mRNA, whereas 92.3% of tumors greater than 9 cm were positive for IGF-II mRNA. These results show that IGF-II mRNA and protein can be readily detected in many tumors, even when the tumors are not associated with clinical hypoglycemia. The expression and production of this growth factor cannot accurately predict patients with clinical evidence of hypoglycemia.

Journal Article↗

Percoll Density Gradient-Enriched Populations of Rat Pituitary Cells: Interleukin 6 Secretion, Proliferative Activity, and Nitric Oxide Synthase Expression.

We used a discontinuous Percoll density gradient centrifugation to prepare enriched populations of prolactin (PRL), growth hormone (GH), and folliculo-stellate (FS) cells from rat anterior pituitaries in order to characterize these various cell populations. After cell dissociation and centrifugation, enriched PRL cells (55% of total cells as determined by immunocytochemistry [ICC] were present in Fraction 1 (Fr1) (density ([d]) = 1.059). Fr2 (d=1.071) had enriched S100-positive FS cells (31% of total cells), but enriched GH cell (60% of total cells) were present in Fr3 (d=1.094). Interleukin 6 (IL-6) was secreted mainly by enriched PRL cells in Fr1 (350 pg/mL/106 cells) and Fr2 (194 pg/mL/106 cells), and much less by the enriched GH cells inFr3 (16 pg/mL/106). Proliferation studies with combined 3H-thymidine and ICC for pituitary hormones showed that only the PRL cell had significant prolifereative activity. Immunostaining showed that immediately after separation, all three isoforms of nitric oxide synthase (NOS) were expressed anterior pituitary cells. After 3 d of culture, there was a marked increase in nuclear staining for neuronal NOS (nNOS) in all three fractions, whereas inducible NOS (iNOS) and endothelial NOS (eNOS) rexpression did not change significantly. These results indicate that: 1. Enriched populations of PRL, FS, and GH pituitary cells can be readily obtained with a rapid discontinuous percoll density separation procedure. 2. PRL cells from different fractions of the gradient show differenet proliferation rates and IL-6 secretion varied in different enriched cell populations. 3. Although all three isoforms of NOS were expressed in rat pituitary cells, nNOS is the prindipal isoform in anterior pituitary cells, and its expression was icreased after 3 d of culture of anterior pitutuitary cells.

Journal Article↗

Prevalence and Prognostic Significance of Neuroendocrine Differentiation in Colorectal Carcinomas.

The prognostic significance of neuroendocrine differentiation in colorectal carcinoma is uncertain. We analyzed 289 moderately differentiated (grades II and Ill) colorectal carcinomas for neuroendocrine differentiation by immunohistochemistry and in situ hybridization. The tumors were divided into three groups based on the presence of and the numbers of neuroendocrine cells, with group I having no neuroendocrine cells, group II having <1 positive cell/mm(2), and group Ill with >1 positive cell/mm(2). In situ hybridization with probes for chromogranin A and B detected almost twice as many neuroendocrine cells as did immunostaining with an antibody for chromogranin A. There was no prognostic difference associated with the presence or absence of neuroendocrine differentiation in this group of moderately differentiated carcinomas. These results indicate that the presence of neuroendocrine cells detected by expression of chromogranin protein or mRNA does not influence prognosis in moderately differentiated colorectal carcinomas.

Journal Article↗

Analysis of TGF-B and TGF-B-RII in Thyroid Neoplasms from the United States, Japan, and China.

Transforming growth factor B (TGF-B) has an inhibitory effect on cell proliferation in various cells and tumors, so loss of TG-B-receptor (TGF-B-R) may lead to increase proliferative activity in these tumors. We compared the expression of TGF-B and TGF-B-Rll in a group of thyroid neoplasms from the United States, Japan, and China to determine if there were differences in the expression of this growth factor or its receptors in various tumor types from different countries. A total 108 neoplastic thyroids from the United States, 42 from Japan, and 46 from China were analyzed for TGF-B1, TGF-B3, and TGF-B-Rll by in situ hybridization with riboprobes. TGF-jB-RII expression was also examined by immunohistochemistry. TGF-B1 mRNA was expressed in all neoplastic thyroids from all three countries except for one anaplasti carcinoma (ACA). TGF-B3 expression was lowest in follicular carcinomas (FCA) from all three countries (30/42; 71%). TGF-B-RII was much lower in FCA from Japan (112; 50%) and China (6/11; 55%) compared to cases from the United States (26/29; 90%). TGF-B-RII expression in papillary carcinoma (PCA) was also lower in carcinomas from Japan (21/28; 75%) and China (23/30; 77%) compared to the United States (24/25; 96%). Most ACA from the United States (25/30; 83%) and from China (3/3; 100%) were positive for TGF-B-Rll. Immunohistochemical analysis for TGF-B-RII protein expression showed the highest levels in follicular adenomas (FA) (38/38; 100%) with decreased immunoreactivity in FCA (36142; 86%). PCA (66/83; 80%), and ACA (14/33; 42%). These findings suggest that loss of TGF-B--RII may be important in thyroid tumor progression and that environmental/geographic factors may play a role in the variable expression of TGF-B--RII in thyroid malignancy.

Journal Article↗

Remodeling of Hyperplastic Pituitaries in Hypothyroid us-Subunit Knockout Mice After Thyroxine and 1713-Estradiol Treatment: Role of Apoptosis.

Hyperplasia of pituitary thyrotrophs is often associated with hypothyroidism. In this study. the effects of thyroxine and 1 7B-estradiol on thyrotroph hyperplasia was analyzed using a hypothyroid mouse model resulting from targeted disruption of the glycoprotein hormone a-subunit (aSU) gene, which leads to lack of functional thyroid-stimulating hormone (TSH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) and underdevelopment of the thyroid and gonads. Thyroxine replacement for 2 mo resulted in a decrease in the relative percent of thyrotrophs and an increase of lactotrophs and somatotrophs numbers to normal values. A twofold increase in the relative percent of gonadotrophs was observed compared to wild-type mouse pituitary. Treatment for 2 mo with 17B-estradiol led to an increase in lactotroph numbers to normal levels, but had no influence on thyrotroph hyperplasia. Rearrangement of the hyperplastic pituitary phenotype after hormonal replacement proceeded without any evidence of pituitary cell necrosis. A slight increase in apoptotic cell death was observed in hormone-treated pituitaries, and this was localized to TSH cells by double-labeling experiments. Chronic thyroxine treatment resulted in increased expression of Bcl-2 protein in hypertrophied pituitary cells, whereas 17f3-estradiol increased expression of Bad protein in prolactin cells. These results suggest that apoptotic cell death is involved in reversal of thyrotroph hyperplasia in the presence of thyroid hormone. Thyroxine and 17-estradiol may influence cell death in this model by regulating expression of the Bcl-2 protein family in a celltype specific manner.

Journal Article↗

Pituitary Changes in Ataxia-Telangiectasia Syndrome: An Immunocytochemical, In Situ Hybridization, and DNA Cytometric Study of Three Cases.

Ataxia-telangiectasia (AT) syndrome (cerebellar ataxia, oculocutaneous telangiectasias, immunodeficiency, susceptibility to infections, and neoplasia) is associated with cyto- and nucleomegaly in several organ systems. Our aim was to determine (1) whether such cellular abnormalities in the pituitary selectively involve specific cell types, and (2) the proliferation and DNA ploidy status of such cells. Three AT autopsy pituitaries were studied by histology, immunohistochemistry (pituitary hormones, MIB-1, p53 protein), in situ hybridization (pituitary hormones), and Feulgen stain image analysis for ploidy. Results indicated that, in adenohypophyses the scattered pleomorphic, bizarre nuclei were mainly those of somatotrophs and corticotrophs, growth hormone (GH), or adrenocorticotropic hormone (ACm) immunoreactive and expressing the GH or ACTH gene, respectively. Cyto- and nucleomegaly were less frequent in other secretory cells but were also noted in pituicytes of the posterior lobe. Affected cells were immunonegative for MIB-1 and for p53 protein. Image morphometric DNA analysis showed the bizarre cells to be aneuploid with complex histogram patterns, including many nuclei with DNA contents >8 n. No adenomas were found. We conclude that in AT adenohypophyseal cells with cyto- and nucleomegaly, as well as pleomorphism, synthesize and store adenohypophyseal hormones, mainly GH or ACTH. They and affected pituicytes are nonproliferative and are aneuploid.

Journal Article↗

TGF-B and Estrogen Regulate P27(Kip1) and Cyclin D(1) in Normal and Neoplastic Rat Pituitary Cells.

Pituitary hyperplasia and tumor growth are regulated by various hormones and growth factors. Estrogen (E(2)) stimulates pituitary cell proliferation and prolactin (PRL) production. Estrogen also regulates transforming growth factor-B (TGF-B) effects in the pituitary. IGF-B in turn regulates various cell cycle proteins including p15 and p27(Kip1) (p27). To better understand the regulatory role of growth factors and hormones in the cell cycle we analyzed cyclin D(1), cyclin E, and p27 expression in normal and neoplastic rat pituitary cells. An in vitro analysis using cultured normal pituitary cells and GH(3) tumor cells and an in vivo analysis of estrogen-treated normal pituitary and implanted GH(3) cells were performed. Semiquantitative RT-PCR was used to analyze mRNA expression for cyclin D(1) cyclin E, and p27 in cultured pituitary cells and E(2)-treated pituitaries in vivo, Cyclin D(1) and p27 were localized in the nuclei of normal pituitary cells by immunocytochemistry (ICC). Very weak or absent immunostaining for cyclin D(1) and p27 was present in GH(3) cells. Both normal pituitary and GH(3) cells had strong nuclear staining for cyclin E. Normal pituitary had a 20-fold greater amount of cyclin D mRNA and a 3-fold greater amount of p27 mRNA compared to GH cells, whereas GH cells had slightly (1.5-fold) more cyclin E than normal pituitary cells. Treatment in vivo stimulated cell proliferation and decreased cyclin D(1) mRNA levels in normal pituitary. GH(3) tumor cells, implanted subcutaneously in the same animal, showed increased proliferation after E(2) treatment, but there was no change in cyclin B(1) mRNA in GH(3) cells. Cyclin E and p27 mRNA levels did not change significantly in normal pituitary or in GH(3) cells after E(2) treatment in vivo. Treatment of normal pituitary cells with 10(-9)M TGF-B1 for 3 d in vitro led to significant decreases in cyclin B(1) and p27 mRNAs (p < 0.05 ), whereas cyclin E levels were unchanged. These results indicate that cyclin B(1) and p27 mRNAs are present at significantly higher levels in normal pituitary compared to GH(3) cells, and that both E(2) and TGF-B1 can down-regulate cyclin B(1) mRNA levels in normal pituitary cells, suggesting that these factors regulate G1 to S phase transition in pituitary cells. The lower levels of specific cell cycle regulators in GH cells may explain the decreased regulatory control by E(2) in GH(3) tumor cells.

Journal Article↗

TGFB, TGFB Receptors, Ki-67, and p27(Kip)l Expression in Papillary Thyroid Carcinomas.

Although most papillary thyroid carcinomas behave as low-grade neoplasms and are generally associated with a good prognosis, some subgroups of these neoplasms represent more aggressive variants. In order to determine if differences in the behavior of these papillary carcinomas were related to expression of growth factors or cell-cycle proteins, we analyzed a series of papillary carcinomas including the conventional or usual type (n = 27), tall cell (n = 27), diffuse sclerosing (n = 5), and columnar cell (n = 2) variants for expression of transforming growth factor beta (TGB), TGB receptors (TGB-RI and II, the proliferation marker Ki-67, and for the cell-cycle inhibitory protein p27(Kip)1 (p27). All groups of thyroid tumors expressed TGFB and TGFB-RI and RlI by immunohistochemical staining. There was a marked increase in the Ki-67 labeling index after staining with antibody MIB-1 in the columnar cell tumors compared to the other groups, but this difference was not significant because of the small number of tumors in this group. The cell-cycle inhibitory protein p27 was expressed in all groups and was not significantly different between groups. Normal thyroid cells had a higher labeling index for p27 compared to papillary carcinomas. These results indicate that TGFB and TGFB receptors I and II are commonly expressed in the usual and in variant forms of papillary thyroid carcinomas, and that there is decreased expression of p27 protein in all of these neoplasms compared to normal thyroid. The biological basis for the more aggressive behavior of these variants of papillary thyroid carcinoma remains uncertain.

Journal Article↗

Growth Factors.

Growth factors are polypeptides that interact with specific cellular receptors leading to many different biological responses. There are various families of growth factors that have similar biochemical structures. Although many growth factors stimulate cell proliferation, a few have primarily inhibitory functions, such as transforming growth factor-p (TGFB). Growth factors regulate various modes of action of endocrine tissues, including autocrine, paracrine, and endocrine functions. Recent studies have shown that growth factors also regulate various proteins in the cell cycle, and may have a direct or indirect effect on cell proliferation. For example, TGFB regulates various inhibitory cell-cycle proteins, including p27(kip1) and p15(INK4B). Molecular analyses of growth factors, including the cloning and sequencing of specific growth factor receptors, have contributed greatly to our understanding of the role these factors play in cellular homeostasis and neoplastic development.

Journal Article↗

Overview of Neuroendocrine Cells and Tumors.

The diffuse neuroendocrine system (DNES) is composed of cells and tumors with secretory granules ranging from 50-400 nm in diameter. Members of the DNES commonly stain for chromogranin and synaptophysin by immunohistochemistry and may express a variety of peptide hormones. Recent studies have shown that the proprotein convertases (proconvertases or PCs) are good broad-spectrum markers for members of the DNES. Gene expression can be readily detecting in neuroendocrine cells and tumors by in situ hybridization (ISH). Newer techniques such as in situ polymerase chain reaction (PCR) can be used to detect gene products that are expressed in low copy numbers in neuroendocrine cells. The concept of multidirectional differentiation is an important notion that helps to explain multiple patterns of phenotypic expression observed in some neuroendocrine tumors.

Journal Article↗

Expression and Regulation of Transforming Growth Factor B1 in Cultured Normal and Neoplastic Rat Pituitary Cells.

Pituitary prolactin (PRL) cell gene expression and proliferation are regulated by hormones and growth factors. Transforming growth factor beta (TGFB) and blast growth factor (bFGF) have been implicated in the regulation of antenor pituitary function. To study the roles of TGFB and bFGF in anterior pituitary cell function, we analyzed normal and neoplastic pituitary cells in serum-free media. The various isoforms of TGFB and TGFB receptor types I, II, and III were also analyzed by reverse transcription-polymerase chain reaction (RT-PCR) in pituitary cells. Transforming growth factor beta 1 (TGFB1) stimulated PRL expression and PRL cell proliferation in normal pituitary. TGFB1 stimulated PRL expression, but inhibited proliferation in the growth hormone (GH) and PRL-producing GH(3) cells. Estradiol 17 B (E(2)) and bFGE stimulated PRL gene expression in normal pituitary and GH(3) cells, whereas E(2) inhibited and bFGF stimulated TGFB1 mRNA levels in normal pituitary PRL cells, but not in GH(3) cells. Both normal pituitary and GH(3) cells expressed the mRNAs for TGFB1, TGFB2, and TGFB3 isoforms and for TGFB receptors I, II, and III. These results indicate that there is a relative loss of regulatory control by growth factors in neoplastic GH(3) cells compared to normal pituitary PRL cells.

Journal Article↗

The Immunophenotype of Pituitary Adenomas.

Although the production of pituitary hormones by adenohypophysial tumors has been studied extensively, an examination of the immunophenotype of pituitary adenomas using a broad spectrum of antibodies has not been previously investigated. We studied 23 pituitary adenomas using a large panel of antibodies to determine if these tumors exhibited a common immunophenotype. Various neuroendocrine markers, synaptophysin, neuron-specific enolase (NSE), and the intermediate filament protein, low-mol-wt keratin were expressed in most examples. There was, however, differential expression of chromogranin A in that few prolactin (PRL) and adenocorticotrophic hormone (ACTH) adenomas stained positively, whereas all other adenoma subtypes were reactive. The ACTH adenomas had a unique profile with positive staining for galanin, neurophysiri, vasopressin, and ubiquitin. These results indicate that (1) pituitary adenomas do not express a single "generic" immunophenotype; (2) synaptophysin is the most reliable and best broad spectrum marker for pituitary adenomas; (3) the neuroendocrine granule marker chromogranin A is useful in the identification of null cell adenoma, a tumor that usually does not stain for anterior pituitary tumors; and (4) among pituitary tumors, ACTH adenomas have a unique immunoprofile.

Journal Article↗

Immunohistochemical Analysis of the Cell Cycle-Associated Antigens Ki-67 and Retinoblastoma Protein in Parathyroid Carcinomas and Adenomas.

The morphologic distinction between parathyroid carcinoma and adenoma can be a difficult diagnostic problem. We analyzed nuclear immunoreactivity for the cell cycle-associated antigen Ki-67 with monoclonal antibody (MAb) MIB-1 and for retinoblastoma (RB) protein with two polyclonal antisera in 24 parathyroid carcinomas and 35 adenomas, which were formalin fixed and paraffin embedded to determine if these antibodies could assist in distinguishing between carcinomas and adenomas. In addition, 10 cases of parathyroid hyperplasia and 5 cases of normal parathyroids were examined as control tissues. The Ki-67 labeling index was significantly higher in parathyroid carcinomas compared to adenomas (7.1 +/- 1.0% vs 2.4 +/- 0.2%, p <0.001). No patient with a parathyroid adenoma, parathyroid hyperplasia, or normal parathyroid gland had a Ki-67 labeling index >5.3%. Analysis of the primary tumors from patients with recurrent carcinomas and from those with nonrecurrent carcinomas showed a higher mean Ki-67 labeling index (7.8 +/- 1.5% vs 5.2 +/- 1.1%) in the former group. Although these differences were not statistically significant, the RB protein immunoreactivity was not useful in distinguishing between parathyroid carcinomas and adenomas in paraffin-tissue sections. These results indicate that nuclear immunoreactivity for the cell cycle-associated antigen Ki-67 may be another useful method to assist in distinguishing parathyroid carcinomas from adenomas.

Journal Article↗

The Pituitary in Gigantism.

To compare the pituitary pathology of gigantism to that of acromegaly, 19 surgically resected lesions were studied from 10 males and 9 females, ages 13-49 (mean, 19 yr) with excessive height (>/=95th percentile), onset of disease prior to puberty, elevated growth hormone (GH) levels despite glucose suppression, and a pathologically confirmed GH-producing pituitary mass. One patient had MEN-I. The lesions included 18 adenomas and 1 case of pure hyperplasia. The median, mean, and range of serum GH and prolactin (PRL) levels were 64, 235, 5-1000 ng/mL and 47, 146, 29-770 ng/mL, respectively. Of the 8 adenoma specimens accompanied by nontumoral pituitary (i.e., tissue wherein the presence of hyperplasia was assessable), 3 (37%) demonstrated both. Of the 18 tumors, 78% were macroadenomas and 22% were grossly invasive; their immunophenotypes included GH (5%), GH and PRL (19%), and GHPRL and a glycoprotein hormone, usually TSH and/or a-subunit (76%). Of the 10 adenoma-containing lesions subject to electron microscopy (EM), 2 consisted of GH cells alone; 2 of mammosomatotroph (MS) cells alone; 1 of GH and MS cells; 1 of GH and PRL cells; 2 of GH, PRL, and MS cells; 1 of GH, PRL, and glycoprotein cells; and 1 was a subtype 3 adenoma. Ultrastructurally, GH cells and/or MS cells predominated in these lesions. Immuno-EM of one CH and PRL cell and of one GH-PR-MS tumor showed GH and PRL to be present not only in single cells but within the same granules. Nine of 12 adenoma-associated lesions subject to combined in situ hybridization (ISH) and immunostaining showed double labeling for PRL (or GH) mRNA and for GH (or PRL), respectively, features indicating MS differentiation. In the 4 lesions exhibiting hyperplasia, either alone (1) or in association with adenoma (3), EM showed MS cells in 3, and immuno-EM as well as combined immunohistochemistry and ISH showed double labeling for GH and PRL in both of the 2 cases studied. In summary, although in terms of their tinctorial characteristics and tumor size, the lesions of giants resemble those of acromegalics, those of the former are less often invasive and glycoprotein hormone containing, and more often contain ultrastructurally distinctive MS cells. The high frequency of adenoma with hyperplasia (37%) and the occurrence of hyperplasia alone (6%) is of particular notice since this finding is rare in patients with acromegaly. Hyperplasia is, however, seen in ectopic GH-releasing hormone production and the McCune-Albright syndrome. We conclude that the presence of MS is not rare in the pituitary lesions of patients with gigantism. Their presence may be a reflection of either hypothalamic dysfunction or of an intrinsic abnormality of pituitary cells,

Journal Article↗