The Relationship of “Crooke's Changes” in the Basophilic Cells of the Anterior Pituitary Body to Cushing's Syndrome (Pituitary Basophilism)

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Abstract
The author has traced the steps that led to the development of the thesis that each and every case of Cushing''s syndrome is in reality a case of a specific type of primary or secondary hyperadrenocorticism. It is not necessary to conclude that Crooke''s changes are in any way implicated in the pathogenesis of the associated clinical syndrome. Rather than being an expression of cause, it is just as logical to assume them to be an expression of effect. In other words, they may indicate a secondary or retrograde, but not necessarily a degenerative, phenomenon, analogous, for example, to the cytologic changes that occur in the ant. pituitary body after castration or thyroidectomy. When regarded in this manner, the author presents evidence to show that Crooke''s changes support rather than conflict with the thesis that Cushing''s syndrome is largely an ex-pression of hyperadrenocorticism. A physiologic mechanism by which Crooke''s changes might occur has been illustrated by various types of cases of Cushing''s syndrome.

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