Corticotroph Adenomas

Question 1

What leads to adrenal hypersecretion of cortisol and the development of hypercortisolism= cushing syndrome?

Answer 1

Excess production of ACTH by functioning corticotroph adenomas

Question 2

What is called when the hypercortisolism is caused by excessive production of ACTH by the pituitary?

Answer 2

Cushing disease

Question 3

At what state are they usually discovered? What method is used to diagnos?

Answer 3

Usually small microadenomas when diagnosed

• Can be stained by PAS due to accumulation of glycosylated ACTH protein
• ACTH can also be specifically detected by immunohistochemical methods.

Question 4

What is Nelson Syndrome?

Answer 4

Sometimes, when people with Cushing syndrome get their adrenal glands removed to treat the condition, a large and aggressive type of tumor called corticotroph cell adenoma can develop. This is known as Nelson syndrome. It happens because the adrenal corticosteroids that were inhibiting a small corticotroph tumor are now gone. Because the adrenals have been removed, people with Nelson syndrome don’t experience high cortisol levels, but instead may have symptoms caused by the pituitary tumor growing larger

Question 5

How does Cushing syndrome manifest on the patients?

Answer 5

Hyperpigmented skin because of increased production of melanocyte stimulating hormone (MSH), which is derived from the same precursor as ACTH so its synthesis accompanies that of ACTH.