EFFECT OF DOPAMINE AGONIST MEDICATION ON PROLACTIN PRODUCING PITUITARY-ADENOMAS - A MORPHOLOGICAL-STUDY INCLUDING IMMUNOCYTOCHEMISTRY, ELECTRON-MICROSCOPY AND INSITU HYBRIDIZATION

被引:79
作者
KOVACS, K
STEFANEANU, L
HORVATH, E
LLOYD, RV
LANCRANJAN, I
BUCHFELDER, M
FAHLBUSCH, R
机构
[1] UNIV MICHIGAN,DEPT PATHOL,ANN ARBOR,MI 48109
[2] SANDOZ PHARMACEUT,DIV NEUROENDOCRINOL,BASEL,SWITZERLAND
[3] UNIV ERLANGEN NURNBERG,DEPT NEUROSURG,W-8520 ERLANGEN,GERMANY
关键词
BROMOCRIPTINE; PITUITARY NEOPLASM; PROLACTIN; ULTRASTRUCTURE;
D O I
10.1007/BF01605931
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
Conventional light microscopy, immunocyto-chemistry, electron microscopy and in situ hybridization were used to evaluate the effect of dopamine agonists (bromocriptine-LAR and bromocriptine) on the morphology of surgically removed prolactin (PRL)-producing pituitary adenomas. dopamine agonist therapy resulted in decrease of serum PRL, clinical improvement and tumour shrinkage. Using light and electron microscopy cellular atrophy, interstitial and perivascular fibrosis were noted; in several tumours connective tissue accumulation was pronounced. The cellular response was not uniform. In some adenomas populations of large cells and small cells were distinguished. The large cells contained immunoreactive PRL and expressed the PRL gene indicating resistance to dopamine agonists. It appears that these cells retained the potential to secrete PRL and proliferate despite exposure to dopamine agonists. In the small cells, PRL immunoreactivity and PRL gene expression decreased providing evidence that both PRL release and synthesis were blocked. Small cells can persist in tumours after discontinuation of dopamine agonist medication suggesting these small cells are irreversibly suppressed and are not capable of regaining their endocrine function and proliferative capability. The formation of irreversibly suppressed PRL cells may explain why some PRL-producing adenomas do not recur after withdrawal of dopamine agonists.
引用
收藏
页码:439 / 446
页数:8
相关论文
共 48 条
[1]   GONADOTROPIN-SECRETION INVITRO BY HUMAN PITUITARY NULL-CELL ADENOMAS AND ONCOCYTOMAS [J].
ASA, SL ;
GERRIE, BM ;
SINGER, W ;
HORVATH, E ;
KOVACS, K ;
SMYTH, HS .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1986, 62 (05) :1011-1019
[2]  
BANNISTER P, 1987, BRIT J CLIN PRACT, V41, P712
[3]   CLINICAL AND PATHOLOGICAL EFFECTS OF BROMOCRIPTINE ON PROLACTIN-SECRETING AND OTHER PITUITARY-TUMORS [J].
BARROW, DL ;
TINDALL, GT ;
KOVACS, K ;
THORNER, MO ;
HORVATH, E ;
HOFFMAN, JC .
JOURNAL OF NEUROSURGERY, 1984, 60 (01) :1-7
[4]   BROMOCRIPTINE TREATMENT REDUCES THE CELL-SIZE IN HUMAN MACROPROLACTINOMAS - A MORPHOMETRIC STUDY [J].
BASSETTI, M ;
SPADA, A ;
PEZZO, G ;
GIANNATTASIO, G .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1984, 58 (02) :268-273
[5]   FAILURE OF BROMOCRIPTINE TO MAINTAIN REDUCTION IN SIZE OF A MACROPROLACTINOMA [J].
BREIDAHL, HD ;
TOPLISS, DJ ;
PIKE, JW .
BRITISH MEDICAL JOURNAL, 1983, 287 (6390) :451-452
[6]   DOPAMINERGIC RECEPTORS IN HUMAN PROLACTIN-SECRETING ADENOMAS - A QUANTITATIVE STUDY [J].
BRESSION, D ;
BRANDI, AM ;
MARTRES, MP ;
NOUSBAUM, A ;
CESSELIN, F ;
RACADOT, J ;
PEILLON, F .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1980, 51 (05) :1037-1043
[7]   BROMOCRIPTINE-UNRESPONSIVE PROLACTIN MACROADENOMA IN A PREPUBERTAL FEMALE [J].
CHEYNE, KL ;
LIGHTNER, ES ;
COMERCI, GD .
JOURNAL OF ADOLESCENT HEALTH, 1988, 9 (04) :331-334
[8]  
CHIODINI P, 1981, J CLIN ENDOCR METAB, V52, P727
[9]   EFFECTS OF A NEW LONG-ACTING FORM OF BROMOCRIPTINE ON TUMOROUS HYPERPROLACTINEMIA [J].
CICCARELLI, E ;
GHIGO, E ;
MAZZA, E ;
ANDREIS, M ;
MASSARA, F ;
LANCRANJAN, I ;
CAMANNI, F .
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 1987, 10 (02) :179-182
[10]  
CORENBLUM B, 1981, FERTIL STERIL, V36, P716