AI Article Synopsis
- Two cases of hormonal disorders (Cushing's syndrome and acromegaly) were diagnosed using human pituitary tissue in cell culture, despite not detecting pituitary tumors.
- Case 1 involved a small cell carcinoma where, although it didn't secrete detectable ACTH, the culture medium contained a substance similar to human CRF that stimulated ACTH secretion from pituitary cells.
- Case 2 had a lung tumor that secreted a growth-hormone releasing factor (GRF), and its removal resolved the acromegaly symptoms, confirming that ectopic secretion of these factors was responsible for the patients' conditions.
Article Abstract
Cell culture of human pituitary tissue has been used to diagnose a patient with Cushing's syndrome due to ectopic secretion of corticotrophin-releasing factor (CRF; case 1) and a case of acromegaly associated with ectopic secretion of a growth-hormone releasing factor (GRF; case 2). In both patients a pituitary tumour was not detected. Case 1 had a small cell carcinoma and symptoms of the ectopic ACTH syndrome, but in culture the carcinoma failed to secrete detectable ACTH. However, the culture medium used to maintain this carcinoma in vitro was found to contain a substance which stimulated ACTH secretion by human pituitary corticotrophs in cell culture. Radioimmunoassays and HPLC indicated that this substance had similar elution characteristics to human CRF and cross-reacted with antiserum to ovine CRF. Case 2 was found to have a lung tumour, the removal of which led to regression of her acromegalic symptoms. In culture, this tumour did not secrete GH, but did secrete a GRF. We conclude that the Cushing's syndrome and acromegaly, in cases 1 and 2, respectively, were due to ectopic secretion of CRF and GRF leading to hyperstimulation of the pituitary gland.
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