The treatment of a slowly growing invasive prolactinoma with bromocriptine for 8 months resulted in a substantial decrease in plasma prolactin levels despite rapid suprasellar tumor expansion. On exploration, this uncommon observation could be attributed to hematogenous metastasis from an occult gastric adenocarcinoma to the pituitary tumor. Apart from infiltration of neighboring parts of the hypothalamus, autopsy revealed no other hematogenous metastases. This extraordinary type of neoplasm-to-neoplasm metastasis was not shown by computed tomography. This possibility should be considered whenever progressive growth of a pituitary mass is accompanied by a decrease in hormonal overproduction.
The results are presented of a clinical-enzyme histochemical evaluation of the activity of acetylcholinesterase in the rectal mucosa of 46 children with obstipation. In four cases abundant and coarse acetylcholinesterase positive nerve fibres were present in the lamina propria of the mucosa. Only in these 4 cases was the diagnosis of Hirschsprung's disease supported by the clinical course. Local accumulations of fine acetylcholinesterase positive nerve fibres or accumulations of acetylcholinesterase positive foamy or structureless material were not correlated with Hirschsprung's disease.
A method is described, combining immunohistochemistry and histological staining methods in the same section, for the identification of ACTH- and STH-producing cells in formalin-fixed, routine processed human pituitary tissue. The results indicate that this method is suitable to employ in practice.
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