PMC9381334_01
Pituitary enhanced magnetic resonance imaging (MRI) showed pituitary tumor (upper panel). The size of the pituitary tumor was up to 11 mm in diameter (white arrow). Histopathological findings (lower panel). Hematoxylin and Eosin staining of the pituitary gland (magnification10x20). The pituitary gland was filled with tumor cells with round nuclei and eosinophilic cytoplasm. ACTH staining of the pituitary gland (10x10). Pituitary adenoma cells were diffusely stained on ACTH staining.
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ACTH (103.3 pg/mL to 108.2 pg/mL) (Cushing's disease: >150% rise of ACTH) and cortisol (20.2 mug/dL to 31.1 mug/dL) continuously for 2 hours. A desmopressin challenge test was not performed, but enhanced magnetic resonance imaging (MRI) revealed a pituitary tumor 11 mm in diameter (Fig. 1). In addition, pituitary adenoma cells were diffusely stained by ACTH staining (Fig. 1).
Chest and abdominal enhanced computed tomography (CT) one month before (left upper panel) and two months after (right upper and right lower panel) the diagnosis of Cushing's disease. Enhanced chest and abdominal CT two months after the diagnosis of Cushing's disease revealed Stanford type A aortic dissection spreading from the aortic arch to the renal arterial branch, although this had not been observed one month before the diagnosis.
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As shown in Fig. 2 (right upper and right lower panel), chest and abdominal enhanced computed tomography (CT) revealed Stanford type A aortic dissection spreading from the aortic arch to the renal arterial branch that had not been observed three months earlier by chest or abdominal CT (Fig. 2 left panel).