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Severe Obesity Associated With Pituitary Corticotroph Hyperplasia and Neoplasia.
Lochner, Riley H; Delfin, Luvy; Nezami, Behtash G; Cohen, Mark L; Asa, Sylvia L; Burguera, Bartolome; Couce, Marta E.
Afiliación
  • Lochner RH; Department of Pathology, Houston Methodist Hospital, Houston, Texas.
  • Delfin L; Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
  • Nezami BG; Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
  • Cohen ML; Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
  • Asa SL; Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
  • Burguera B; Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: burgueb@ccf.org.
  • Couce ME; Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio. Electronic address: Marta.couce@uhhospitals.org.
Endocr Pract ; 29(6): 471-477, 2023 Jun.
Article en En | MEDLINE | ID: mdl-37004872
OBJECTIVE: To investigate the incidence of corticotroph hyperplasia (CH) or lymphocyte infiltration in the pituitary of patients with obesity. METHODS: The pituitary and adrenal glands from 161 adult autopsies performed between 2010 and 2019 at our institution were reviewed. The clinical history, body mass index (BMI), and cause of death were recorded. Routine hematoxylin and eosin staining, reticulin staining, and immunohistochemical staining for adrenocorticotropic hormone, CD3, and CD20 were performed. The results were analyzed using the Fisher and chi-square statistics. Decedents were separated into 4 groups based on BMI (kg/m2): (1) lean (BMI, <25.0), (2) overweight (BMI, 25.0-29.9), (3) obesity class I (BMI, 30.0-34.9), and (4) obesity classes II to III (BMI, >34.9). RESULTS: CH/neoplasia was identified in 44 of 161 pituitary glands. Four (9.1%) of 53 lean patients had pituitary lesions, whereas 27.3% (12) of overweight, 22.7% (10) of obesity class I, and 40.9% (18) of obesity class II patients had hyperplasia (P < .0001). Small corticotroph tumors were identified in 15 patients; only 1 was a lean patient, and the tumor was associated with the Crooke hyaline change of nontumorous corticotrophs. The presence of CH and neoplasia was associated with adrenal cortical hyperplasia and lipid depletion. Microscopic foci of T and B lymphocytes were identified in the pituitaries of patients in each weight category; no independent association between BMI and lymphocyte inflammation was found. CONCLUSION: Our data indicate an association between CH/neoplasia and obesity. It remains unclear whether obesity is the cause or effect of adrenocorticotropic hormone and cortisol excess.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de la Hipófisis / Neoplasias Hipofisarias / Obesidad Mórbida Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Endocr Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades de la Hipófisis / Neoplasias Hipofisarias / Obesidad Mórbida Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Endocr Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos