1 University of Iowa, College of Medicine, Department of Anatomy, lowa city, lowa 52240
2 University of Washington, Seattle
In Dr. Gilbert S. Omenn's1 otherwise excellent review of ectopic hormone syndromes associated with tumors in childhood we find the following sentence: "Completely characterized cases of ectopic ACTH syndrome have bilateral adrenal hyperplasia, normal pituitary basophils, positive assay for ACTH in the tumor, and failure of suppression of elevated plasma ACTH by dexamethasone." I have no personal experience with the ectopic ACTH syndrome in childhood, but in three cases seen in adults the basophils (more accurately, the ACTH-MSH cells among them), far from being normal, showed the expected profound Crooke's hyalinization characteristic of severe hypercortisolism.2