Summary
The islets of Langerhans of diabetic and non-diabetic patients with different degrees of islet amyloidosis were studied by electron microscopy. The islet amyloid exhibited the typical fine fibrillar ultrastructure and was mainly located interstitially. Adjacent to the β cells the amyloid fibrils were often highly orientated perpendicularly to the cell surface and bundles of amyloid fibrils entered in deep plasmalemmal invaginations of the cells. This was more rarely seen in other types of cell. The epithelial cells exhibited no signs of increased activity. Macrophages were common in the amyloid masses. Amyloid occurred in invaginations of these cells but usually the fibrils showed no orientation. The capillaries, the fibrocytes and the mast cells were not so closely related to the amyloid. These findings probably indicate that the amyloid of the islets of Langerhans is a product of degenerating β cells even if other possibilities are not excluded.
Zusammenfassung
Die Ultrastruktur der Langerhansschen Inseln bei der Inselamyloidose.
Die Langerhansschen Inseln diabetischer und nicht-diabetischer Patienten mit verschiedenen Schweregraden einer Inselamyloidose wurden elektronenmikroskopisch untersucht. Das Inselamyloid zeigte eine typische feinfibrilläre Ultrastruktur und war vorwiegend interstitiell lokalisiert. In der Nachbarschaft der β-Zellen waren die Amyloidfibrillen oft senkrecht zur Zelloberfläche orientiert, wobei Bündel von Amyloidifibrillen in tiefe Invaginationen der Zellgrenzmembran hineinragten. Diese Beobachtung fand sich selten bei den anderen Inselzelltypen. Die Epithelzellen zeigten keine Hinweise auf eine gesteigerte Aktivität. Im Bereich der Amyloidmassen fanden sich in der Regel Makrophagen. Das Amyloid war in den Invaginationen dieser Zellen erkennbar, allerdings gewöhnlich nicht in paralleler Orientierung. Capillaren, Fibrocyten und Mastzellen waren dem Amyloid weniger dicht benachbart. Aus den Befunden wird der Schluß gezogen, daß das Amyloid der Langerhansschen Inseln ein Produkt degenerierender β-Zellen darstellt. Andere Möglichkeiten der Entstehung lassen sich allerdings nicht ausschließen.
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Supported by the Swedish Medical Research Council (project No. B73-12X-102-09B, the Research Fund of the Swedish Diabetes Association, the Swedish Society for Medical Research and the Medical Faculty of Uppsala. Thanks are due to Ann-Charlotte Hallner, Lena Rönning and Anders Strand for their skilled technical assistance.
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Westermark, P. Fine structure of islets of Langerhans in insular amyloidosis. Virchows Arch. Abt. A Path. Anat. 359, 1–18 (1973). https://doi.org/10.1007/BF00549079
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DOI: https://doi.org/10.1007/BF00549079