Adrenocorticotropin-containing neoplastic cells in a pars intermedia adenoma in a horse

Pituitary-dependent hyperadrenocorticism was diagnosed in a 14-year-old Arabian mare with chronic weight loss, hirsutism, polyuria, and polydipsia. The mare had a stress leukogram, glucosuria, and consistent hyperglycemia. Plasma glucose concentrations were resistant to suppression by insulin. Plasma cortisol concentrations were within normal limits, but did not respond to dexamethasone suppression and had an exaggerated response to ACTH stimulation. At necropsy, a chromophobe adenoma of the pars intermedia of the pituitary gland was found. The zona fasciculata of the adrenal cortex and the pancreatic islets of Langerhans were hypertrophied. An immunohistologic staining technique was used to demonstrate ACTH-containing neoplastic cells in the pituitary mass. These cells released ACTH and other peptides that initiated the chain of endocrinologic events leading to clinical disease.     

Necrotizing mycotic vasculitis with cerebral infarction caused by Aspergillus niger in a horse with acute typholocolitis.

An 18-year-old Morgan mare was presented to the Veterinary Medical Teaching Hospital, University of Illinois, with a 10-day history of watery diarrhea, depression, and dysphagia. On admission, the animal was severely dehydrated, depressed, and unable to swallow and had no clinical signs of diarrhea. The respiratory and heart rate and body temperature were within normal limits. Following fluid therapy, the mare developed severe watery diarrhea and continued to be depressed, incoordinated, and dysphagic. The animal died on the fourth day after admission and was sent to the Laboratories of Veterinary Diagnostic Medicine for necropsy. Gross postmortem findings were consistent with an acute cerebral infarction in the right cerebral hemisphere, an acute necrotizing typhlocolitis, multifocal petechial and ecchymotic hemorrhages, enlarged and congested pars intermedia of the pituitary gland, and marked bilateral adrenocortical hyperplasia with multifocal areas of necrosis and hemorrhage. Histologic evaluation of the affected brain demonstrated an area of coagulative necrosis of the gray matter, with hemorrhage, vasculitis, and thrombosis. There were many fungal hyphae 3.5-6.0 microm, pale basophilic, septate, and occasionally branching at 45 degrees present in the arterial walls and throughout the necrotic tissue. Immunohistochemical analysis revealed Aspergillus niger as the etiologic agent responsible for the mycotic vasculitis and infarction in the brain. Bacteria culture and immunohistochemical staining of the colon and cecum failed to demonstrate specific pathogens.     

Evaluation of pituitary gland anatomy and histopathologic findings in clinically normal horses and horses and ponies with pituitary pars intermedia adenoma

OBJECTIVE: To determine size and weight of the pituitary gland and associations between pituitary gland size and weight and sex and age in horses without clinical signs associated with pituitary pars intermedia adenoma (PPIA) and horses and ponies with PPIA. ANIMALS: Pituitary glands from 100 horses without clinical signs of PPIA and 19 horses and 17 ponies with PPIA. PROCEDURES: Pituitary glands were weighed, measured, and examined histologically by use of H&E stain. Masson trichrome and periodic acid-Schiff staining were used, when appropriate. Histologic lesions in the pars intermedia, pars distalis, or both were classified as no significant lesions, single or multiple cysts, focal or multifocal hyperplasia, single or multiple microadenomas, and adenoma. Relative pituitary weight (RPW) was calculated as pituitary weight (grams) divided by body weight (grams). RESULTS: There was an age-related increase in the presence of pituitary lesions in the pars distalis and pars intermedia in geldings, mares overall, and non-pregnant mares. Mean (+/-SD) RPW in horses with PPIA was not significantly different from ponies with PPIA (15+/-5.9 x 10(-6) and 16+/-72 x 10(-6), respectively). Maximum pituitary weight in a horse with PPIA was 13.9 g (RPW, 2.9 X 10(-5)). Plasma glucose concentration was positively correlated with RPW in ponies with PPIA. CONCLUSIONS AND CLINICAL RELEVANCE: Pituitary lesions may be a factor in horses with insulin resistance and laminitis before development of clinical signs of PPIA. Ovarian steroids may be involved in the pathogenesis of lesions in the pars intermedia.     

Systemic and pituitary pars intermedia antioxidant capacity associated with pars intermedia oxidative stress and dysfunction in horses

OBJECTIVE: To determine whether a deficiency in systemic or local (pars intermedia) antioxidant capacity is associated with pituitary pars intermedia oxidative stress and pituitary pars intermedia dysfunction (PPID) in horses. SAMPLE POPULATION: Blood samples from 20 horses with PPID and 20 healthy client-owned horses, archived paraffin-embedded adrenal gland and substantia nigra tissues from 20 horses, and pituitary gland tissue from 16 horses. PROCEDURES: Total glutathione, superoxide dismutase, and glutathione peroxidase activities were determined in RBCs. Accumulation of a systemic marker of oxidative stress (3-nitrotyrosine) was assessed in plasma and formalin-fixed, paraffin-embedded adrenal gland and substantia nigra tissues. Local antioxidants (total and manganese superoxide dismutase, glutathione peroxidase, and total glutathione) were measured in pars intermedia tissues. RESULTS: No significant differences existed in systemic antioxidant enzyme activity or accumulation of 3-nitrotyrosine between horses with PPID and control horses. In pituitary gland tissues, glutathione peroxidase activity was increased in horses with oxidative stress, whereas total glutathione concentration and superoxide dismutase activity remained unchanged. There was an age-associated decrease in manganese superoxide dismutase activity in the pars intermedia. CONCLUSIONS AND CLINICAL RELEVANCE: There was no evidence of systemic accumulation of oxidative stress markers or deficiencies in antioxidant capacity in horses with PPID, suggesting that these are unlikely to be major predisposing factors in the development of PPID. Manganese superoxide dismutase activity in the pars intermedia decreased significantly with increasing age. Role of an age-associated decrease in antioxidant capacity for the pars intermedia in the development of PPID in horses warrants further investigation.     

Adrenocorticotropin concentration following administration of thyrotropin-releasing hormone in healthy horses and those with pituitary pars intermedia dysfunction and pituitary gland hyperplasia

OBJECTIVE: To compare the effect of thyrotropin-releasing hormone (TRH) administration on endogenous ACTH concentrations in healthy horses and those with pituitary pars inter-media hyperplasia and compare the test with the dexamethasone suppression test (DST). DESIGN: Prospective case series. ANIMALS: 15 horses with clinical signs of pituitary pars intermedia dysfunction (PPID), 4 horses with equivocal signs of PPID, and 29 horses without signs of PPID. PROCEDURES: ACTH concentrations prior to and after administration of TRH were measured 61 times in 48 horses. Results of the DST (cortisol response) were compared with those of the TRH test in 29 horses. Thirty-three horses (24 with no clinical signs of PPID, 5 with clinical signs of PPID, and 4 with equivocal clinical signs of PPID) were euthanized and necropsied and their pituitary glands evaluated. RESULTS: ACTH concentrations increased in all horses, but magnitude and duration of increase were significantly higher in horses with PPID. Endogenous ACTH concentrations were influenced by season. The ACTH baseline concentrations and response to TRH were not correlated with results of the DST. Results of DST were abnormal only in clinically abnormal horses or those with pars intermedia hyperplasia, but were within reference range in 17 of 26 tests in these horses. CONCLUSIONS AND CLINICAL RELEVANCE: The ACTH response to TRH is a useful test for diagnosis of pituitary gland hyperplasia, particularly in horses in which baseline ACTH concentrations are within reference range. The DST was specific but not sensitive and was inconsistent for individuals, and results often did not agree with the TRH test response.     

Autologous Platelet Concentrates as an Adjunctive Treatment for Chronic Laminitis in a Mare with Pituitary Pars Intermedia Dysfunction

The aim of this article was to describe a case of a 7-year-old mare with chronic laminitis secondary to pituitary pars intermedia dysfunction that was successfully treated with autologous platelet concentrates (APC) obtained by the tube method, 4 months before being treated with oral pergolide. After the diagnosis of pituitary pars intermedia dysfunction, the patient was treated with three intralesional injections of APC at 10-day intervals. APC presented a mean concentration of 430 ± 22 × 10⁶ platelets and 8.6 ± 1.3 leukocytes/mL. The treatment with APC produced growth of the hooves at a rate of 5 mm/wk and substantially reduced the foot pain (lameness) after two APC applications. The mare could be ridden 2 weeks after the third APC treatment. The treatment with oral pergolide 4 months later improved the clinical picture of the patient, albeit hirsutism remained. APC could be useful as adjunctive treatment of chronic laminitis in horses. However, additional clinical studies are necessary to determine the safety and effectiveness of APC in chronic laminitis.     

Perianesthetic development of diaphragmatic hernia in a horse with equine pituitary pars intermedia dysfunction (PPID)

A 21-year-old Thoroughbred gelding with a history of equine pituitary pars intermedia dysfunction (PPID) presented with priapism of 2 days’ duration. The horse received a caudal morphine epidural and then underwent corpus cavernosum lavage and phallectomy under general anesthesia. The patient’s recovery featured multiple unsuccessful attempts to stand and his respiratory distress persisted for several hours until he acutely developed severe colic and was euthanized. Necropsy findings revealed a pituitary adenoma of the pars intermedia, bilateral adrenal cortical hyperplasia, and diaphragmatic herniation. This report suggests that horses with PPID may present a greater risk for diaphragmatic hernia under general anesthesia or during procedures placing stress on the diaphragm, including anesthetic recovery.     

Diabetes insipidus associated with metastatic pancreatic carcinoma in a dog

Diabetes insipidus was diagnosed in a dog with metastatic pancreatic carcinoma. Histologic examination of the pituitary gland revealed extensive invasion of the pars intermedia and neurohypophysis by metastatic tumor cells.     

FSH分泌细胞在皖西白鹅脑垂体中的分布与定位

采用免疫组化SABC法并结合DAB显色技术时皖西白鹩脑垂体结构和促卵泡素(follicular stimulating hormone,FSH)分泌细胞进行了研究和定位.结果发现,皖西白鹅的垂体前叶由远侧部和结节部构成,没有中间部.垂体FSH免疫阳性细胞分布广泛,但前叶远侧部分布较多,从而表明皖西白鹅整个垂体都有FSH分泌,主要分泌部位在垂体前叶的远侧部.     

Facial cutaneous phaeohyphomycosis associated with Alternaria infectoriae infection

Cutaneous nodular disease in the horse is relatively rare and usually associated with arthropod bites, dermal hyperplasia and inflammatory or neoplastic infiltrates. Equine phaeohyphomycosis, particularly alternariosis, has been previously described in the literature and is usually associated with Alternaria alternata. In this article we report a case of phaeohyphomycosis caused by a member of Alternaria section Infectoriae in a horse. To our knowledge this is the first time that this organism has been identified in equids. Despite A. Infectoriae being commonly isolated in individuals receiving immunosuppressive therapy and/or suffering from Cushing's syndrome, we could not determine a link between pituitary pars intermedia dysfunction and fungal infection in this case. The mare responded well to surgical excision of the cutaneous lesions and made a full recovery.     

Central Diabetes Insipidus in a Dog With a Pro-Opiomelanocortin-Producing Pituitary Tumor ot Causing Hyperadrenocorticism

Central diabetes insipidus was diagnosed by vasopressin measurements during hypertonic stimulation in a 9-year-old male giant Schnauzer with polyuria and polydipsia. The impaired release of vasopressin was believed to be caused by a large pituitary tumor, which was visualized by computed tomography. Studies of the function of the anterior lobe and the pars intermedia of the pituitary gland were conducted, and high concentrations of ACTH and α-melanotrophic hormone (α-MSH) were found without concomitant hyperadrenocorticism. Studies of the molecular size of the immunoreactive ACTH in plasma by gel filtration revealed that most of the circulating immunoreactivity was not ACTH but its precursor pro-opiomelanocortin (POMC) and low-molecular-weight POMC-derived peptides. The pituitary tumor of this dog probably originated from melanotrophic cells of the pars intermedia. The sensitivity of the pituitary-adrenocortical system for the suppressive effect of dexamethasone was unaffected.     

Agreement in histologic assessments of the pituitary pars intermedia in aged horses

OBJECTIVE: To evaluate concordance among veterinary pathologists in the assessment of histologic findings in the pars intermedia of pituitary gland sections from aged horses with mild signs suggestive of pituitary pars intermedia dysfunction (PPID). Sample Population-10 pituitary glands from aged horses. PROCEDURE: 7 pathologists were provided with signalment, clinical signs, and a single H&E-stained pituitary gland section from 10 aged horses with mild signs suggestive of PPID. Pathologists described histologic findings for each section and stated whether findings were consistent with PPID. Agreement among pathologists and with antemortem diagnostic test results was calculated. RESULTS: Overall, only fair agreement was found among the pathologists as to which horses had histologic findings consistent with disease (mean +/- SE kappa value, 0.34 +/- 0.069). Interpretation of individual sections varied, with minimal agreement (4 or 5/7 pathologists) for 5 of 10 sections evaluated. Postmortem assessment was in agreement with an antemortem endocrine diagnostic test result 79% of the time. CONCLUSIONS AND CLINICAL RELEVANCE: Validation of antemortem diagnostic testing for PPID in horses often relies on the results of postmortem histologic evaluation. The lack of consensus in histologic interpretation of pituitary glands from aged horses with mild clinical signs in our study indicates that postmortem histologic evaluation of pituitary glands is an inappropriate standard in validation of antemortem diagnostic tests for detection of early PPID. Caution should be used when interpreting diagnostic test results in horses in which early PPID is suspected.     

Immunocytochemical demonstration of proopiomelanocortin-derived peptides in pituitary adenomas of the pars intermedia in horses

Adenomas of the pars intermedia from 19 horses and normal pituitary glands from seven horses were evaluated histologically and immunocytochemically for adrenocorticotropic hormone (ACTH), alpha-melanocyte-stimulating hormone (alpha-MSH), beta-endorphin (beta-END), proopiomelanocortin (POMC), prolactin, neuron specific enolase, and glial fibrillary acidic protein (GFAP). The 26 horses ranged in age from 7 to 31 years. Histologically, all adenomas had a uniform pattern characterized by cords of large columnar cells forming palisades and pseudoacini separated by a delicate fibrovascular stroma. Immunostaining of adenomas derived from the pars intermedia was similar to that of non-neoplastic equine pars intermedia. An immunocytochemical evaluation revealed a diffuse, strong cytoplasmic reaction for POMC, a moderate to strong reaction for alpha-MSH and beta-END, a weak reaction for ACTH, and negative immunostaining for prolactin, GFAP, and neuron specific enolase in the adenomas. The unique clinicopathologic syndrome that develops in horses with pituitary adenomas appears to be the result of an over-production of POMC-derived peptides in addition to space-occupying effects resulting in dysfunction of the hypothalamus and neurohypophysis.     

Extrapituitary and Pituitary Pathological Findings in Horses with Pituitary Pars Intermedia Dysfunction: A Retrospective Study

The objective of this study was to describe the histopathologic changes observed in extrapituitary organs as well as the pituitary glands of horses with pituitary pars intermedia dysfunction (PPID). Adrenal gland, thyroid gland, liver, lung, kidney, heart, and pituitary gland from 32 horses with clinical and histologic evidence of PPID and 20 control horses were reviewed histologically. Ten of the control horses were aged animals (≥15 years), allowing those changes attributed to age to be identified. In addition to previously reported changes in adrenal gland and liver, an association was established between PPID and several extrapituitary histopathologic changes, namely bronchiolitis, proliferative glomerulopathy, and myocardial lipofuscinosis and fibrosis. The potential biologic significance of these changes is discussed and, although the retrospective design of the current study precludes establishment of causal relationships between the observed extrapituitary changes and PPID, these findings suggest that further investigations are warranted.     

The Effect of Season on the Histologic and Histomorphometric Appearance of the Equine Pituitary Gland

The objective of this study was to determine the effect of season on the histologic and histomorphometric appearance of the normal equine pituitary gland. Pituitary glands were collected at necropsy from 121 horses throughout the year. Plasma was also collected from 59 of these horses before euthanasia. Hematoxylin and eosin stained median sagittal sections of each pituitary were evaluated and histologically graded by three pathologists. Histomorphometric analysis was performed on the same slides. Plasma α-melanocyte stimulating hormone was measured by radioimmunoassay in a subset of horses (n = 59). A total of 118 pituitary glands were included in the study after exclusions were made on the basis of the presence of pars intermedia (PI) adenomas (>5 mm). There was a positive correlation between PI hormone concentration (α-melanocyte stimulating hormone) and PI area. Pituitary gland measurements and grades from samples collected in the fall were compared with those collected in the nonfall months using t-test. The PI area, total pituitary area, and PI/total pituitary ratio were significantly greater in the fall compared with nonfall months (P < .0001, P < .01, P < .0001, respectively). Pituitary grades were also higher in the fall compared with nonfall months (P < .001). There was no seasonal difference in pars distalis or pars nervosa area. The results of this study show that the normal equine pituitary shows seasonal changes in appearance and size. These changes must be considered when using postmortem histologic evaluations in the diagnosis of pituitary pars intermedia dysfunction or for validation of antemortem diagnostic tests.     

Correlation of pituitary histomorphometry with adrenocorticotrophic hormone response to domperidone administration in the diagnosis of equine pituitary pars intermedia dysfunction

Functional evaluation of the pars intermedia (PI) is required for the early diagnosis of equine pituitary PI dysfunction (PPID), yet most assays target the hypothalamic-pituitary-adrenal axis, which regulates the pars anterior. In contrast, the PI is regulated by dopaminergic tone from hypothalamic neurons. Loss of dopaminergic inhibition is hypothesized to cause the PI hypertrophy and hyperplasia that result in the clinical manifestations of PPID. Domperidone, a dopamine receptor antagonist, should exacerbate the loss of dopaminergic inhibition in horses with PPID and increase the release of endogenous adrenocorticotrophic hormone (eACTH) by PI melanotrophs. To test this, plasma eACTH concentration was determined in horses with or without clinical signs of PPID at 0, 4, and 8 hours after oral administration of 3.3 mg domperidone/kg. Pituitary glands were evaluated postmortem by histologic grading and morphometry. In the 33 horses, median age, plasma ACTH concentration 8 hours after domperidone, and PI area in median sagittal sections were associated with histologic grade as follows: pituitary grade 1 (normal), n = 3, 7.5 years, 20.0 pg/ml, 0.16 cm(2); grade 2 (focal hypertrophy or hyperplasia), n = 9, 14.5 years, 27.1 pg/ml, 0.27 cm(2); grade 3 (diffuse adenomatous hyperplasia), n = 5, 21.0 years, 64.4 pg/ml, 0.48 cm(2); grade 4 (microadenomas), n = 12, 23.3 years, 128.0 pg/ml, 0.87 cm(2); grade 5 (adenoma), n = 4, 24.9 years, 720.5 pg/ml, 2.1 cm(2). Results suggest that horses with pituitary histologic grade > or =3 respond to domperidone with increased plasma ACTH concentration.     

Orexin‐B‐like immunoreactivity in pituitary αMSH‐producing cells and median eminence GnRH‐containing fibres of the flat‐tailed house gecko

We examined the distribution of the orexin‐like peptides in the pituitary and median eminence of the flat‐tailed house gecko (Hemidactylus platyurus) using immunohistochemistry. Orexin‐B‐like, but not orexin‐A‐like, immunoreactivity was detected in the pituitary, specifically in the pars intermedia, and these cells corresponded to alpha‐melanocyte‐stimulating hormone (αMSH)‐producing cells. Orexin‐B and αMSH secreted from pars intermedia may modulate secretion of adenohypophyseal cells in the pars distalis. In the median eminence, orexin‐B‐immunoreactive puncta and fibres were observed, and these structures corresponded to gonadotropin‐releasing hormone (GnRH)‐immunoreactive puncta and fibres. Orexin‐B secreted from GnRH‐containing neurons in the hypothalamus may affect thyrotropin‐releasing hormone‐containing neurons resulting in modulation of αMSH secretion of melanotrophs in the pars intermedia.     

Localization of the N-methyl-D-aspartate R1 Receptor in the Pituitary Gland of Immature Rainbow Trout (Oncorhynchus mykiss)

A study was conducted on the selective immunostaining of pituitary cells and pars nervosa of immature rainbow trout by antibody raised against the R1 subunit of the rat ionotropic N-methyl-D-aspartate (NMDA) receptor. In the pars distalis, the mammotrophs of the rostral pars distalis exhibited the most marked imunoreactivity, with the somatotrophs of the proximal pars distalis showing a consistently lower degree of immunoreactivity. No imunoreactivity was associated with the corticotrophs, thyrotrophs or gonadotrophs. In the pars intermedia, the melanotrophs showed no evidence of immunoreactivity, whereas the putative somatomammotrophs exhibited a wide inter-animal range of immunoreactivity. Some imunostaining was also evident in the anterior and posterior part of the pars nervosa, at the interface of the pars distalis or pars intermedia with the pars nervosa.     

Expression of leukemia inhibitory factor and leukemia inhibitory factor receptor in the canine pituitary gland and corticotrope adenomas

Leukemia inhibitory factor (LIF) is a pleiotropic cytokine of the IL-6 family that activates the hypothalamic-pituitary-adrenal axis and promotes corticotrope cell differentiation during development. The aim of this study was to investigate the expression of LIF and its receptor (LIFR) in the canine pituitary gland and in corticotrope adenomas, and to perform a mutation analysis of LIFR. Using immunohistochemistry, immunofluorescence, and quantitative expression analysis, LIF and LIFR expression were studied in pituitary glands of control dogs and in specimens of corticotrope adenoma tissue collected through hypophysectomy in dogs with pituitary-dependent hypercortisolism (PDH, Cushing's disease). Using sequence analysis, cDNA was screened for mutations in the LIFR. In the control pituitary tissues and corticotrope adenomas, there was a low magnitude of LIF expression. The LIFR, however, was highly expressed and co-localized with ACTH_1-24 expression. Cytoplasmatic immunoreactivity of LIFR was preserved in corticotrope adenomas and adjacent nontumorous cells of pars intermedia. No mutation was found on mutation analysis of the complete LIFR cDNA. Surprisingly, nuclear to perinuclear immunoreactivity for LIFR was present in nontumorous pituitary cells of the pars distalis in 10 of 12 tissue specimens from PDH dogs. These data show that LIFR is highly co-expressed with adrenocorticotropic hormone (ACTH) and α-melanocyte-stimulating hormone (α-MSH) in the canine pituitary gland and in corticotrope adenomas. Nuclear immunoreactivity for LIFR in nontumorous cells of the pars distalis may indicate the presence of a corticotrope adenoma.     

Naturally occurring lesions in some endocrine glands of laboratory maintained baboons (Papio sp.)

The pituitary gland was examined from 623 immature baboons (Papio cynocephalus and Papio anubis). Findings included microscopic cysts in the pars distalis (132), pars intermedia (two) and pars nervosa (one). In 641 necropsies five cases of unilateral thyroid glands were noted. Microscopic thyroid lesions included ectopic thymus (328), minor lymphocytic infiltrates (14) and cysts (two). Parathyroid lesions consisted of ectopic thymus (73) and cysts (24). Dilated capillaries in the islets of Langerhans was the only microscopic change seen in the endocrine pancreas. All lesions generally occurred in both untreated control and treated baboons at similar incidences. They were considered to be naturally occurring, a part of the "background" pathology of these endocrine glands in immature baboons.