This Article Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by PEILLON, F. Articles by DEROME, P. Search for Related Content PubMed PubMed Citation Articles by PEILLON, F. Articles by DEROME, P.

Pituitary Enlargement with Suprasellar Extension in Functional Hyperprolactinemia due to Lactotroph Hyperplasia: A Pseudotumoral Disease

INSERM U.223, Faculté de Médecine Pitié-Salpêtrière 75013 Paris
Service de Neurochirurgie, Hôpital Foch 92151 Suresnes
Laboratoire de Biochimie B, Hôpital Necker 75015 Paris
Pharmacologie Endocrinienne, Hôpital Lariboisière 75010 Paris, France

Address all correspondence and requests for reprints to: Dr. F. Peillon, INSERM U.223, Faculté de Médecine Pitié-Salpêtrière, 105 boulevard de l'Hôpital, 75013 Paris, France.

Beside the well characterized PRL-secreting adenomas, a wide spectrum of functional hyperprolactinemic states exists. We describe here five women, 21–38 yr old, all suspected of having a PRL-secreting adenoma because of a pseudotumoral appearance of the pituitary on computerized tomographic (CT) scan or magnetic resonance imaging (MRI). Four had oligomenorrhea with or without galactorrhea, one had amenorrhea with galactorrhea, and two complained of infertility. In the same patient, basal plasma PRL levels were variable on different days, sometimes normal (mean ± SEM, 11.3 ± 1.5 µg/L), sometimes elevated (49 ± 7 µg/L), but in all cases, a PRL response of large amplitude to TRH (6- to 8-fold increase in the basal value) was observed. Basal plasma levels of estradiol were within luteal phase normal values (0.41 ± 0.13 pmol/L), while progesterone levels were low (1.92 ± 0.47 nmol/L). CT scan or MRI showed an intrasellar mass with suprasellar extension, suggesting a tumoral process. However, the signal intensity was homogeneous, and on coronal views, the suprasellar extension was pyramidal and symmetrical, and the pituitary stalk was always in the midline. The five patients were operated on by the transsphenoidal route, but no adenoma was found. Surgical biopsies were taken in four cases, and lactotroph hyperplasia, i.e. enlarged cell cords consisting mainly of PRL cells, was found in three of them. One case displayed a continuum between areas of lactotroph hyperplasia and adenomatous PRL cells. We conclude that functional hyperprolactinemia may mimic on CT scan or MRI a PRL-secreting adenoma.

Received May 22, 1990.

This article has been cited by other articles:

				P. Chanson, F. Daujat, J. Young, A. Bellucci, M. Kujas, D. Doyon, and G. Schaison Normal Pituitary Hypertrophy as a Frequent Cause of Pituitary Incidentaloma: A Follow-Up Study J. Clin. Endocrinol. Metab., July 1, 2001; 86(7): 3009 - 3015. [Abstract] [Full Text] [PDF]