Frequency and activity of autorosette forming cells in Con-A activated PBL from women with hyperplasia or carcinoma of the endometrium--possible role of estrogens.

In a previous study we showed that endometrial carcinoma (EC) patients have a T cell deficiency manifested in a reduced ability to be stimulated in vitro by PHA and to produce IL-2. In an attempt to understand the mechanism responsible for this alteration we present in this paper a study on T cells characterized by the ability to form rosettes, with human erythrocytes, following Con-A activation (designated auto-rosette forming cells--ARFC). These cells are also known to manifest suppressive activity. We show that the frequency of ARFC in con-A activated peripheral blood leukocytes (PBMC) of EC patients is significantly (2-5 fold) higher than that of healthy age-matched controls or that of patients with stage--I colon or vaginal cancer. Endometrial carcinoma is known to be associated with long term exposure to estrogens unopposed by progestins. Examining the possible role of estrogens in increasing the frequency of ARFC from EC patients, we found that in vitro addition of estradiol to Con-A stimulated PBMC from healthy donors increased the frequency of ARFC to levels found in EC patients. Tamoxifen, an anti estrogen drug, reduced the frequency of the estrogen stimulated ARFC to the original low level. Our results suggest a dual role for estrogen in carcinogenesis as well as in immunomodulation.

Spontaneous postpartum regression of pituitary mass with return of function.

A 37-year-old woman undergoing endocrine evaluation during her seventh pregnancy because of headaches, weakness, and hyponatremia was found to have central hypoadrenalism and hypothyroidism. Computed tomography showed a pituitary mass with suprasellar extension but her visual fields were intact. She was treated conservatively with hydrocortisone acetate and levothyroxine sodium until 38 weeks of gestation, when healthy twins were delivered by cesarean section. A few months later, her pituitary function improved, with a significant increase in the adrenocorticotropic hormone level, normal values of basal thyroid-stimulating hormone, growth hormone, and gonadotropins and of their functional reserves, and only a slight elevation in the prolactin level. A repeated computed tomographic scan showed disappearance of the pituitary mass.