Digestive Diseases and Sciences

, Volume 36, Issue 7, pp 933–942 | Cite as

Clinical pathology of endocrine tumors of the pancreas

Analysis of autopsy cases
  • Wataru Kimura
  • Akira Kuroda
  • Yasuhiko Morioka
Original Articles

Abstract

A clinicopathological analysis of endocrine tumors of the pancreas, using 800 autopsy cases (422 men, 378 women, mean age 78.7) was accomplished. The results were: (1) Endocrine tumors and similar lesions were found in 3% or 24 cases (25 lesions). Twenty lesions (20 cases) were found to be tumors and five lesions (five cases) were determined to be hyperplasia of Langerhans islets. (2) Incidence of tumor was 10% (6/60) in individuals having histological studies of all sections of the pancreas, and 1.6% (12/738) in individuals having histological studies of three random sections of the pancreas. (3) None of the cases with tumors and hyperplastic lesions showed symptoms of hormone production. (4) Immunohistochemical analysis revealed hormone production in all 20 tumor cases and multiple hormone production was found in 14 of these (70%). (5) Ductular or tubular structures were found in or adjacent to the tumors in 12 cases (60%) and hyperplasia in one case (20%). Langerhans islets, 500 μm or larger in size, were found in three lesions of the tumor (15%). Langerhans islets with the mean diameter of normal islets +2sd or larger also were found around five tumors (25%) and three hyperplasias (60%). The above findings suggest that endocrine tumors of the pancreas are prevalent and that they do not produce symptoms of excessive hormone production even though they do continue to produce hormones. Some of the endocrine tumors or hyperplasias develop from totipotent stem cells of the duct epithelia, and factors promoting the growth of Langerhans islets might exist.

Key Words

endocrine tumor pancreatic tumor hyperplasia Langerhans islets immunohistochemical analysis hormone production pathogenesis 

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References

  1. 1.
    Heitz PU, Kasper M, Polak JM, Kloeppel G: Pancreatic endocrine tumors. Immunocytochemical analysis of 125 tumors. Hum Pathol 13:263–271, 1982Google Scholar
  2. 2.
    Erlandsen SL: Types of pancreatic islet cells and their immunocytochemical identification.In The Pancreas. PJ Fitzgerald, AB Morrison (eds). Baltimore, Williams & Wilkins, 1980, pp 140–155Google Scholar
  3. 3.
    Moldow RE, Connelly RR: Epidemiology of pancreatic cancer in Connecticut. Gastroenterology 55:677–686, 1968Google Scholar
  4. 4.
    Frantz VK: Islet cell tumors.In Tumor of the Pancreas. VK Frantz (ed). Washington, DC, AFIP, 1959, pp 79–141Google Scholar
  5. 5.
    Becker V: Pathologisch-anatomische Aspekte bei endokrin wirksamen Tumoren. Langenbecks Arch Klin Chir 329:426–437, 1971Google Scholar
  6. 6.
    Warren S, LeCompte PM, Legg MA: The Pathology of Diabetes Mellitus, 4th ed. Philadelphia, Lea & Febiger, 1966Google Scholar
  7. 7.
    Nicholls AG: Simple adenoma of the pancreas arising from an island of Langerhans. J Med Res 8:358–395, 1902Google Scholar
  8. 8.
    Pappenheimer: Quote, by Wipple AO, Frantz VK: Adenoma of islet cell with hyperinsulinism. Ann Surg 101:1299–1335, 1935Google Scholar
  9. 9.
    Lopez-Kruger R, Dockerty MB: Tumors of the islets of Langerhans. Surg Gynecol Obstet 85:495–511, 1947Google Scholar
  10. 10.
    Korpassy B: Die Basalzellenmetaplasie der Ausfuhrungsgange des Pankreas. Virchows Arch Abt A Pathol Anat 303:359–373, 1939Google Scholar
  11. 11.
    Grimelius L, Hultquist GT, Stenkvist B: Cytological differentiation of asymptomatic pancreatic islet cell tumors in autopsy material. Virchows Arch A Pathol Anat Histol 365:275–288, 1975Google Scholar
  12. 12.
    Warren S: Adenomas of the islands of Langerhans. Am J Pathol 2:335–340, 1926Google Scholar
  13. 13.
    Laidlaw GF: Nesidioblastoma, the islet tumor of the pancreas. Am J Pathol 14:125–134, 1938Google Scholar
  14. 14.
    Creutzfeldt W: Endocrine tumors of the pancreas: Clinical, chemical and morphological findings.In The Pancreas. PJ Fitzgerald, AB Morrison (eds) Baltimore, Williams & Wilkins, 1980, pp 208–230Google Scholar
  15. 15.
    Creutzfeldt W, Arnold R, Creutzfeldt C, Track NS: Pathomorphologic, biochemical, and diagnostic aspects of gastrinomas (Zollinger-Ellison syndrome). Hum Pathol 6:47–76, 1975Google Scholar
  16. 16.
    Kimura W, Shimada H, Kuroda A, Morioka Y: Carcinoma of the gallbladder and extrahepatic bile duct in autopsy cases of the aged, with special reference to its relationship to gallstones. Am J Gastroenterol 84:386–390, 1989Google Scholar
  17. 17.
    Kimura W: Histological study on pathogenesis of sites of isolated islets of Langerhans and their course to the terminal state Am J Gastroenterol 84:517–522, 1989Google Scholar
  18. 18.
    Nakane P, Kawaoi A: Peroxidase labeled antibody: A new method of conjugation. J Histochem Cytochem 22:1084–1091, 1974Google Scholar
  19. 19.
    Diamandopoulos Gth, Meissner WA: Neoplasia:IN Anderson's Pathology, Vol 1, 8th ed. JM Kissane (ed). St. Louis, CB Mosby, 1985, pp 514–559Google Scholar
  20. 20.
    Burkhardt L: Inselneubildung im Pankreas bei Stenose des Ausfuhrungsganges durch Pancreaskopfcarcinom. Virchows Arch 20:655–665, 1935Google Scholar
  21. 21.
    Friedlander EO: Hyperinsulinism secondary to disease of pancreas and organs adjacent to the pancreas: A review of the world literature. Ann Intern Med 52:838–848, 1960Google Scholar
  22. 22.
    Bartow SA, Mukai K, Rosai J: Pseudoneoplastic proliferation of endocrine cells in pancreatic fibrosis. Cancer 47:2627–2633, 1981Google Scholar
  23. 23.
    Bloodworth JMB, Greider MH: The endocrine pancreas and diabetes mellitus.In Endocrine Pathology, General and Surgical, 2nd ed. JMB Bloodworth (ed). Baltimore, Williams & Wilkins, 1982, pp 556–620Google Scholar
  24. 24.
    Reid JD, Yuh SL, Petrelli M, Jaffe R: Ductuloinsular tumors of the pancreas: A light, electron microscopic and immunohistochemical study. Cancer 49:908–915, 1982Google Scholar
  25. 25.
    Nonomura A, Mizukami Y, Matsubara F, Kono N, Nakanuma Y: Duct-islet cell tumor of the pancreas: A case report with immunohistochemical and electron microscopic findings. Acta Pathol Jpn 39:328–335, 1989Google Scholar
  26. 26.
    Ulich T, Cheng L, Jewin KJ: Acinar-endocrine cell tumor of the pancreas: Report of a pancreatic tumor containing both zymogen and neuroendocrine granules. Cancer 50:2099–2105, 1982Google Scholar
  27. 27.
    Tomita T, Bhatia P, Gourley W: Mucin producing islet cell adenoma. Hum Pathol 12:850–853, 1981Google Scholar
  28. 28.
    Larsson LI, Grimelius L, Hakanson R, Rehfeld JF, Stadil F, Holst J, Angervall L, Sundler F: Mixed endocrine pancreatic tumors producing several peptide hormones. Am J Pathol 79:271–284, 1975Google Scholar
  29. 29.
    Polak JM, Bloom SR, Adrian TE, Heitz P, Bryant MG, Pease AGE: Pancreatic polypeptide in insulinomas, gastrinomas, VIPomas, and glucagonomas. Lancet 14:328–330, 1976Google Scholar
  30. 30.
    Broder LE, Carter SK: Pancreatic islet cell carcinoma. 1 Clinical features of 52 patients. Ann Intern Med 79:101–107, 1973Google Scholar
  31. 31.
    Cubilla AL, Hajdu SI: Islet cell carcinoma of the pancreas. Arch Pathol 99:204–207, 1975Google Scholar
  32. 32.
    Friedman AC, Krudy AG, Shawker TH, Mitchell DG, Birns MT, Bondner L, Sprayregen SS: Pancreatic neoplasms.In Radiology of the Liver, Biliary Tract, Pancreas and Spleen. AC Friedman (ed). Baltimore, Williams & Wilkins, 1987, pp 749–896Google Scholar
  33. 33.
    Sieracki J, Marshall RB, Horn RC: Tumors of the pancreatic islets. Cancer 13:347–357, 1960Google Scholar
  34. 34.
    Creutzfeldt W, Arnold R: Endocrine tumors of the pancreas.In Bockus Gastroenterology 4th ed. JE Beak (ed) Philadelphia, WB Saunders, 1985, pp 4122–4144Google Scholar

Copyright information

© Plenum Publishing Corporation 1991

Authors and Affiliations

  • Wataru Kimura
    • 1
  • Akira Kuroda
    • 1
  • Yasuhiko Morioka
    • 1
  1. 1.First Department of SurgeryUniversity of TokyoTokyoJapan
  2. 2.TokyoJapan

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