The hypothalamus produces corticotropic hormone, which stimulates corticotrophs
to release ACTH, which then stimulates the adrenal cortex to produce and release cortisol and androgens.
This inadequate ACTH suppression could be due to reduced sensitivity of the corticotrophs in the pituitary gland in which microadenoma or hyperplasia was illustrated in our case.
In our patient, inappropriate secretion of ACTH from a corticotroph adenoma or hyperplasia in a brief period may be described by inappropriate replacement with synthetic glucocorticoid.
Cytochemical identification of human and murine pituitary corticotrophs
and somatotrophs as APUD cells.
It is possible that their hypocortisolic state is related to prolonged compression and irreversible damage to the corticotrophs
More resilient cells include corticotrophs
The anterior lobe consists of several different cell types (somatotrophs, mammotrophs, corticotrophs
, thyrotrophs, and gonadotrophs), which are involved in the biosynthesis and secretion of key hormones (growth hormone, prolactin, adenocorticotropic hormone, thyroid-stimulating hormone, and follicle-stimulating hormone/ luteinizing hormone, respectively) that regulate multiple, diverse, and important physiologic and metabolic functions in the human body (2).
12,13) The periodic acid-Schiff stain is very helpful to identify corticotrophs and is valuable to identify hyperplastic thyrotrophs that exhibit cytoplasmic periodic acid-Schiff-positive droplets.
Exposure to glucocorticoid excess causes corticotrophs to undergo the morphologic alteration known as Crooke hyaline change, (51) accumulation of glassy, homogeneous, pale acidophilic keratin filaments in the cytoplasm, (52,53) that is identified using CAM 5.
Cytokeratin CK20 is a sensitive marker for Crooke's cells and the early cytoskeletal changes associated with hypercortisolism within pituitary corticotrophs.
Corticotropin releasing hormone acts on pituitary corticotrophs
to elicit ACTH release into the circulation.