The visceral and subcutaneous abdominal adipose tissue (AT) area and the subcutaneous hip AT area were assessed by magnetic resonance imaging (MRI) in 12 growth hormone-deficient adults before and after 6 mo of replacement with recombinant human growth hormone (rhGH) and in 12 healthy control subjects. The data obtained by MRI were compared with circumference measurements of waist and hip. Growth hormone-deficient patients compared with control subjects had a higher visceral AT area (P = 0.003) and subcutaneous AT area (P = 0.013); there was no significant difference in subcutaneous hip AT area. Six months of rhGH replacement reduced the subcutaneous hip AT area (19.8%), the subcutaneous abdominal AT area (15.6%), and particularly the visceral AT area (38.2%), resulting in fat areas that were not different from those of control subjects. Furthermore, this study shows that in contrast with control subjects, circumference measurements are not useful to predict AT areas in growth hormone-deficient patients and cannot be used to assess changes in AT areas during rhGH replacement.

To evaluate the effectiveness of CT and MRI at 0.5 T in the diagnosis and staging of retinoblastoma, we studied 11 patients in whom retinoblastoma was clinically suspected. Nine of the eleven had surgically proven retinoblastoma; in the other two a diagnosis of Coats' disease was made. MRI was not as specific as CT for diagnosing retinoblastoma, due to its lack of sensitivity in detecting calcification; it did, however, have superior contrast resolution. On MRI, Coats' disease was reliably diagnosed and easily differentiated from retinoblastoma. Moreover, the greater ability of MRI to differentiate subretinal fluid from tumour also confers high accuracy in measuring tumour size. CT is still the study of choice in the diagnosis of retinoblastoma, but when MRI is available, it should be performed for better differentiation from lesions such as Coats' disease.

Two cases of diffuse histiocytic lymphoma limited to both adrenals are described. Familiarity with these rare lesions will lead to a proper diagnostic approach.

Abstract. Five patients, 3 women and 2 men, with macroprolactinomas characterized by extrasellar extension and basal plasma prolactin levels ranging from 4.6 to 102 U/I received six monthly injections of 50–100 mg Parlodel LAR®, an injectable long-acting repeatable form of bromocriptine. The following observations were made: 1. Plasma prolactin levels fell dramatically in all patients and values in the normal range were obtained in 3 patients. 2. In all patients, the onset of tumour reduction was visible on CT scans made one week after the first Parlodel LAR injection. After six Parlodel LAR injections, tumour size was reduced by more than 75% in 3 patients and by 50–75% in two patients. 3. Diminished visual acuity (one patient), bitemporal hemianopia (2 patients), and oculomotor and trochlear nerve dysfunction (one patient) were restored to normal after the first Parlodel LAR injection. 4. Hypogonadism normalized in 2 patients and improved in one patient, whereas plasma gonadotropins remained low in the 2 postmenopausal women. In one patient with hypothyroidism and hypocorticism, thyroid and adrenal functions normalized. It is concluded that bromocriptine retard (50–100 mg monthly) is a useful alternative for oral treatment of patients with prolactinomas, especially in those patients with compliance problems on oral bromocriptine therapy.

Nineteen patients, seven women and twelve men, with macroprolactinomas characterized by extrasellar extension and basal prolactin levels above 6 U/l were treated with 10-20 mg bromocriptine daily in four divided doses for a mean period of 3.4 years (range 1.5-5.5 years). Plasma prolactin levels fell dramatically in all patients and values in the low normal range were obtained in sixteen patients. Tumor size was reduced by more than 75% in seventeen patients and by 50-75% in two patients. Tumor reduction was associated with the development of a partial empty sella in fourteen cases. In seventeen cases the pituitary became visible. Diminished visual acuity (six patients), bitemporal hemianopia (nine patients), unilateral and bilateral central scotomas (three patients) and oculomotor palsy (two patients) improved or normalized in all cases. Hypogonadism (all patients), hypothyroidism (nine patients) and hypocorticism (four patients) improved or normalized in most cases. It is concluded that in the medical treatment of macroprolactinomas 10-20 mg bromocriptine in four divided doses effectively reduces both plasma prolactin level and tumor size. The good results in this study may be related to the continued use of a fixed dose regimen of bromocriptine regardless of the plasma prolactin lowering effect. RESUME: Resultats du traitement primaire par la bromocriptine des prolactinomes avec extension extrasellaire Dix-neuf patients, septs et douze hommes, porteurs de macroprolactinomes caracteris£s par une extension extrasellaire et des taux de prolactine plasmatique de base superieurs a 6 U/L ont ete traites avec 10-20 mg de Bromocriptine par jour en quatre doses separees pendant une duree moyenne de 3.4 ann£es (ecart de 1.5 a 5.5 annees). Les taux de prolactine plasmatique ont baisse de facon marquee chez tous les patients et des valeurs proches de la normale basse ont 6te" obtenues chez 16 patients. La taille de la tumeur etait reduite de plus de 75% chez dix-sept patients et de 50-75% chez deux patients. La reduction du volume tumoral etait associee avec I'apparition d'une selle partiellement vide dans quatorze cas. Dans dix-sept cas, l'hypophyse normale devenait visible. L'acuite visuelle abaissee (6 patients), PheVnianopsie bitemporale (9 patients), des scotomes centraux uni ou bilateraux (3 patients) et les paralysies oculo-motrices (2 patients) furent ameliores ou se normaliseront dans tous les cas. L'hypogonadisme (tous les patients), l'hypothyroi'die (9 patients) et l'hypocorticisme (4 patients) se sont ameliores ou normalises dans la plupart des cas. Les auteurs concluent que dans le traitement medical des macroprolactinomes, 10-20 mg de de bromocriptine en quatre doses s6parees reduit efficacement et la taille tumorale et le taux plasmatique de prolactine. Les bons rdsultats observes dans cette etude pourraient etre relies a l'utilisation continue d'une zone predeterminee de bromocriptine, quel que soit son effet r6ducteur du taux de prolactine serique.