Acromegaly and thymic hyperplasia: a case report
- 6 Downloads
Growth hormone overproduction is characterized by increased size of visceral organs as well as growth of bone and soft tissues. We describe a case of a 23-year-old female acromegalic patient, who had been previously unsuccessfully operated upon by transsphenoidal pituitary surgery and then irradiated. In November 1987 a routine X-ray chest examination revealed a mediastinal mass, subsequently confirmed by CT scan. The patient underwent surgical removal of the mass: macroscopical aspect, histological sections and immunocytochemistry showed typical thymic structures without any evidence of neurosecretory activity. No GH-positive cells were found and only small amounts of immunoreactive GHRH like material (9.2 ng/g wet wg) were detected in the tumor extract. Before surgery plasma GHRH levels were not elevated (26 pg/ml); serum GH and IGF-I levels were 27.4 ± 4.9 μg/l and 191 nmol/l, respectively, and remained unchanged after surgery. These data ruled out a GHRH and/or GH ectopic production, confirming the primitive pituitary origin of acromegaly in this patient. It is likely that thymic hyperplasia may be explained by longstanding overproduction of GH and the young age of the patient.
Key-wordsGrowth hormone insulin-like growth factor-l growth hormone releasing hormone acromegaly thymus
Unable to display preview. Download preview PDF.
- 2.Rosai J., Levine G.D. Tumors of the thymus. Atlas of tumor pathology. American Forces Institute of Pathology, Washington, 1976, p. 26.Google Scholar
- 3.Soudjian J.V., Moinar G.D., Silverstein M.N., Titus J.L Morphological studies of the thymus in acromegaly, diabetes mellitus, and Cushing’s syndrome. Metabolism 19: 40, 1970.Google Scholar
- 5.Arosio M., Moriondo P., Travaglini P., Ambrosi B., Beck Peccoz P., Conti Puglisi F., Secchi F., Faglia G. Modifications in serum growth hormone concentration induced by sulpiride in acromegalic patients pretreated with dopamine, bromocriptine and meter-goline. J. Clin. Endocrinol. Metab. 51: 454, 1980.PubMedCrossRefGoogle Scholar
- 6.De Toni G., Aicardi G., Bulgarelli R., Dalla Volta A., De Toni E., Gobessi I. Trattato di pediatria e puericultura. Edizioni Minerva Medica, Saluzzo, 1968, Vol. II, p. 358.Google Scholar
- 8.Losa M., Wolfram G., Mojto G., Schopohl J., Spiess Y., Huber R., Müller O.A., Von Werder K. Presence of growth hormone-releasing hormone like-immunoreactivity in human tumors: characterization of immunological and biological properties. J. Clin. Endocrinol. Metab. 70: 62, 1990.PubMedCrossRefGoogle Scholar
- 9.Sternberger I.A. Immunocytochemistry. Prentice-Hall Inc., Englewood Cliffs, New York, 1974.Google Scholar
- 13.Iudd R. L. Massive thymic hyperplasia with myoid cell differentiation. Hum. Pathol. 78: 1180, 1987.Google Scholar
- 14.Rosati A., Pisascane A., Palmieri B., Ruco L.P., Baroni C.D. True thymic hyperplasia: presence of vimentin+/desmin+ cells. Proceedings of XVII International Congress of the International Academy of Pathology and the 8th World Congress of Academic and Environmental Pathology. Dublin, September 4–9, 1988, p. 111. (Abstract)Google Scholar
- 15.Talwar G.P., Hanjan S.N.S., Kidwai Z., Gupta P.D., Mehrotra N.N., Saxena R., Bhattarai Q. Growth hormone action on thymus and lymphoid cells. In: Pecile A., Muller E.E. (Eds.), Growth hormone and related peptides. Elsevier Science Publisher B.V., New York, 1976, p. 104.Google Scholar
- 16.Lesniak M.A., Roth J., Gordon P., Gavin J.R. III. Human growth hormone radioreceptor assay using cultured human lymphocytes. Nature 241: 20, 1973.Google Scholar