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Washington University Experience | NEOPLASM (SELLAR) | Pituitary Adenoma - Pituitary Neuroendocrine Neoplasm | Corticotroph | 9C PA CR (Case 9)CAM52 1.jpg
Perinuclear and cytoplasmic accumulation of intermediate cytokeratin filaments with equivocal 50% majority of tumor cells, confirmation of Crooke's hyaline change. (CAM5.2 IHC) ---- Not shown: Immunohistochemically stained sections show moderate diffuse cytoplasmic reactivity among tumor cells for ACTH. Reactivity for proliferation marker Ki67 stains a small proportion of tumor nuclei ranging up to 3.5%. ---- Comment: These histomorphologic and immunohistochemical features describe an atypical corticotroph cell adenoma with Crooke's hyaline change at the cusp of 50% of the tumor cells involved and was called 'Crooke cell adenoma.' Crooke cell adenoma, sometimes functionally silent and sometimes presenting with Cushing's disease, has been reported to behave in a relatively aggressive manner compared to most macroadenomas.
