Title: B-8. Transsphenoidal Approach to the Pituitary Adenoma, with Special Reference to Postoperative Course of the Human Growth Hormone in Acromegaly
Abstract: It has been known that eosinophilic granules of pituitary adenoma always associate with acromegaly, and further, the intensity of acromegaly depends on the amount of the these granules.However, we experienced a patient of pure eosinophilic pituitary adenoma (Bailey & Cushing, type 1.) without any sign of acromegaly.Because this case showed low concentration of immunoreactive human growth hormone (HGH), either the no-secretion of HGH or secretion of inactive HGH from eosinophilic granules was suspected.On the other hand, three patients of acromegaly showed high concentration of immunoreactive HGH (over 20-50 ng/ml) in plasma.After insulin-induced hypoglycemia and arginine infusion, plasma HGH rose to 80-120 ng/ml, while after the ingestion of 50 g glucose there was no change of plasma HGH.On histological examination these pituitary adenoma cells contained many eosinophilic granules.Electron-microscopic examination revealed many spherical secretory granules (200-400 mu), endoplasmic reticulums and mitochondria.Monolayer cultures of pituitary adenomas from these patients produced much HGH (1000 ng/day, 5 X 105) cells and continued to produce measurable concentration of HGH over the period of a month.On conclusion, eosinophilic granules are not simply responsible to acromegaly, but the amount of HGH released from eosinophilic granules of the pituitary adenoma is more importnat.