The pathology of Cushing's disease.
In this brief review the pathology of Cushing's disease is summarized. The most frequent morphologic abnormality is a basophilic microadenoma of the pituitary accompanied by the Crooke's hyaline change in the cytoplasm of nontumorous corticotrophs. Other tumor variants include chromophobic macroadenomas, Crooke's cell adenomas and corticotroph carcinomas. In some cases, no tumor can be documented in the pituitary. In the adenohypophyses of a few patients with hypercorticism, corticotroph hyperplasia is present which may be the cause of Cushing's disease. The pathogenesis of Cushing's disease is not clear. The question of whether corticotropin-releasing hormone (CRH) plays a role in its genesis has yet to be elucidated. Studies on animals and observations on human pituitaries indicate that CRH can induce accumulation of corticotrophs. Although no evidence is available to prove that CRH is involved in the neoplastic transformation of corticotrophs, it is possible that hypothalamic peptides which stimulate ACTH secretion may play a role in the progression of corticotroph adenoma of the pituitary.
Kovacs
K
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Department of Pathology, St Michael's Hospital, Toronto, Ontario, Canada.
D000818:Animals; D003480:Cushing Syndrome / Q000473:pathology*; D006801:Humans