| Institution: | 1. Department of Pathology, Houston Methodist Hospital, Houston, Texas;2. Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio;3. Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;4. Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio;1. Department of Endocrinology and Nutrition, Ramón y Cajal University Hospital, Madrid, Spain;2. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain;3. Department of Medicine, Universidad de Alcalá, Madrid, Spain;4. Department of Biochemistry, Ramón y Cajal University Hospital, Madrid, Spain;5. Department of Biochemistry and Molecular Genetics, Hospital Clinic, Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain;6. Department of Endocrinology and Nutrition. Hospital Clinic, IDIBAPS, Barcelona, Spain;7. Department of Diagnostic Imaging, Ramón y Cajal University Hospital, Madrid, Spain;8. Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain;1. Division of Pediatric Endocrine, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio;2. Division of Pediatric Gastroenterology, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio;3. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, Ohio;4. Xavier University, College of Arts and Sciences, Cincinnati, Ohio;1. Department of Endocrinology, National Institute of Neurosciences and Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, Bangladesh;2. Department of Neurology, National Institute of Neurosciences and Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, Bangladesh;3. Department of Endocrinology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh;1. Department of Clinical Epidemiology, Clinical Research Unit, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China;2. Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China;3. Aragón Health Research Institute, Zaragoza, Spain;4. University of Zaragoza Faculty of Medicine, Zaragoza, Spain;5. Department of Obstetrics, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China;6. Medical Center of Diagnosis and Treatment for Cervical Disease, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China;1. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Department of Endocrinology, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom |
| Abstract: | ObjectiveTo investigate the incidence of corticotroph hyperplasia (CH) or lymphocyte infiltration in the pituitary of patients with obesity.MethodsThe 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).ResultsCH/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.ConclusionOur 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. |
