Immunoreactive luteinizing hormone in functioning corticotroph adenomas of the pituitary. Immunohistochemical and tissue culture studies of two cases.

Two pituitary adenomas removed from a 37-year-old woman and a 26-year-old woman with typical Cushing's disease were studied by light and electron microscopy, immunohistochemistry and radioimmunoassay of tissue culture media. Both patients had high plasma levels of cortisol and normal levels of luteinizing hormone (LH). Both tumours were monomorphous, composed of densely granulated corticotrophs; the tumour cells contained periodic acid-Schiff positivity, were arranged in a sinusoidal pattern and, ultrastructurally, contained well-developed cytoplasmic organelles. By immunohistochemistry the majority of tumour cells contained immunoreactive adrenocorticotropin (ACTH); approximately 10% of the tumour cell population contained LH immunoreactivity. The LH-positive cells tended to form clusters scattered widely throughout the tumour tissues. LH immunoreactivity was demonstrated in some ACTH-immunoreactive cells on serial sections. Large amounts of immunoreactive ACTH and smaller quantities of LH, follicle stimulating hormone and alpha-subunit were released into the culture media and release of the glycoprotein hormones responded in parallel to corticotropin releasing hormone stimulation or inhibition by cortisol. These findings indicate that LH can be simultaneously produced and released by ACTH-producing tumour cells of otherwise typical functioning corticotroph adenomas. The capacity for LH production may be acquired during neoplastic proliferation. This is the first detailed report of concurrent production of LH by pituitary corticotroph adenomas.