Endocrine Pathology

, 2:111 | Cite as

Pituitary corticotroph adenoma with crooke’s hyalinization

  • Sebastiano Franscella
  • Charles-Abram Favrod-Coune
  • Gianpaolo Pizzolato
  • Sylvia L. Asa
  • Rolf Gaillard
  • Jean Berney
  • Jacques Philippe
Case Report


The diagnosis of pituitary corticotroph adenoma relies on the demonstration of a loss of the normal feedback control of adrenocorticotropic hormone (ACTH) biosynthesis by cortisol. The marked variability in the degree of ACTH suppression by glucocorticoids in these tumors, however, greatly enhances the difficulty in distinguishing Cushing’s disease from other syndromes of glucocorticoid excess. To illustrate this variability, we describe the clinical, biochemical, and morphological characteristics of a pituitary corticotroph adenoma in a 63-year-old woman, who presented with symptoms of a sellar mass but did not initially have florid Cushing’s disease. Light and electron microscopy of the pituitary tumor showed a corticotroph adenoma with Crooke’s hyalinization of the tumor cells, characterized by the accumulation of keratin immunoreactive microfilaments similar to those observed in normal corticotrophs in the presence of excess glucocorticoids. This case illustrates an unusual clinical presentation that may be associated with pituitary corticotroph adenoma showing Crooke’s hyalinization.


Adenoma Pituitary Adenoma Endocrine Pathology Volume Corticotroph Adenoma Excess Glucocorticoid 
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Copyright information

© Humana Press Inc. 1991

Authors and Affiliations

  • Sebastiano Franscella
    • 1
  • Charles-Abram Favrod-Coune
    • 1
  • Gianpaolo Pizzolato
    • 3
  • Sylvia L. Asa
    • 5
  • Rolf Gaillard
    • 1
  • Jean Berney
    • 2
  • Jacques Philippe
    • 1
    • 4
  1. 1.Departments of Medicine (Division of Endocrinology)Hopital Cantonal Universitaire de Geneve and Centre Medical UniversitaireSwitzerland
  2. 2.Departments of Surgery (Division of Oto-Neuro-Surgery)Hopital Cantonal Universitaire de Geneve and Centre Medical UniversitaireGeneva 4Switzerland
  3. 3.Departments of PathologyHopital Cantonal Universitaire de Geneve and Centre Medical UniversitaireGeneva 4Switzerland
  4. 4.Departments of MicrobiologyHopital Cantonal Universitaire de Geneve and Centre Medical UniversitaireGeneva 4Switzerland
  5. 5.Department of PathologySt. Michael’s HospitalTorontoCanada

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