Summary
Morphological and immunocytochemical studies of pancreatic material from eighteen patients with endocrine pancreatic tumours revealed two distinct types of islet abnormalities, both of which were associated with neoformation of endocrine cells from duct epithelium. Due to this phenomenon and the occurrence of greatly increased numbers of certain endocrine cell types the abnormalities were tentatively classified as hyperplasias. Hyperplasia type I was characterized by increases in number of all islet cell types. Increments in numbers of insulin and glucagon cells were most important quantitatively. Neoformation of islet cells from ducts (nesidioblastosis) was especially conspicuous with this type of hyperplasia. To some extent the islet cell neoformation resembled that seen in the human fetal pancreas. Hyperplasia type I was found in addition in two patients having hypergastrinemia due to achlorhydria. It is suggested that this type of abnormality results from a stimulatory effect of gastrin on the formation of pancreatic islet cells. Endocrine pancreatic tumours other than Zollinger-Ellison tumours were frequently, but not invariably, associated with hyperplasia type II, characterized by striking increases in frequency (and conceivably total mass) of pancreatic polypeptide (PP) cells. The variable occurrence of hyperplasia type II could not be related to any specific clinical abnormality. It seems possible that this hyperplasia may represent a non-specific response to pancreatic injury.
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Arnold, R., Creutzfeldt, C., Creutzfeldt, W.: Multiple hormone production of endocrine tumours of the gastrointestinal tract. Proc. IVth Internat. Congr. Endocrinol., Hamburg 1976. Amsterdam: Excerpta Medica (in press)
Creutzfeldt, W., Arnold, R., Creutzfeldt, C., Track, N.S.: Pathomorphologic, biochemical and diagnostic aspects of gastrinomas (Zollinger-Ellison syndrome). Human Pathol. 6, 47–76 (1975)
Floyd, J.C., Chance, R.E., Hayashi, M., Moon, N.E., Fajans, S.S.: Concentrations of a newly recognized pancreatic islet polypeptide in plasma of healthy subjects and in plasma and tumors of patients with insulin-secreting islet cell tumors. Clin. Res. 23, 535 A (1975) (Abstr)
Floyd, J.C., Fajans, S.S., Pek, S., Chance, R.E.: A newly recognized pancreatic polypeptide; plasma levels in health and disease. Proc. 1976 Laurentian Hormone Conference, Quebec (in press)
Gepts, W., de Mey, J., Marichal-Pipeleers, M.: Hyperplasia of “pancreatic polypeptide”-cells in the pancreas of juvenile diabetics. Diabetologia 13, 27–34 (1977)
Larsson, L.I., Boder, G.B., Shaw, W.N.: Changes in the islets of Langerhans in the Zucker obese rat. Lab. Invest. 36, 593–598 (1977)
Larsson, L.I., Grimelius, L., Håkanson, R., Rehfeld, J.F., Stadil, F., Holst, J., Angervall, L., Sundler, F.: Mixed endocrine pancreatic tumors producing several peptide hormones. Amer. J. Pathol. 79, 271–280 (1975)
Larsson, L.I., Hirsch, M.A., Holst, J.J., Ingemansson, S., Kühl, C., Lindkaer Jensen, S., Lundqvist, G., Rehfeld, J.F., Schwartz, T.W.: Pancreatic somatostatinoma, clinical features and physiological implications. Lancet 1, 666–668 (1977)
Larsson, L.I., HØiriis-Nielsen, J., Rehfeld, J.F.: Presence and possible physiological significance of pancreatic gastrin. Diabetologia 12, 404 (1976) (Abstr)
Larsson, L.I., Ljungberg, O., Sundler, F., Håkanson, R., Svensson, S.O., Rehfeld, J.F., Stadil, F., Holst, J.: Antro-pyloric gastrinoma associated with pancreatic nesidioblastosis and proliferation of islets. Virchows Arch. Abt. A Path Anat. 360, 305–314 (1973)
Larsson, L.I., Schwartz, T., Lundqvist, G., Chance, R.E., Sundler, F., Rehfeld, J.F., Grimelius, L., Fahrenkrug, J., Schaffalitzky de Muckadell, O., Moon, N.: Occurrence of human pancreatic polypeptide in pancreatic endocrine tumors. Possible implication in the watery diarrhea syndrome. Am. J. Pathol. 85, 675–684 (1976)
Larsson, L.I., Sundler, F., Håkanson, R.: Immunohistochemical localization of human pancreatic polypeptide (HPP) to a population of islet cells. Cell Tiss. Res. 156, 167–171 (1975)
Larsson, L.I., Sundler, F., Håkanson, R.: Pancreatic polypeptide — A postulated new hormone: Identification of its cellular storage site by light and electron microscopic immunocytochemistry. Diabetologia 12, 211–226 (1976)
Like, A.A., Orci, L.: Embryogenesis of the human pancreatic islets: A light and electron microscopic study. Diabetes 21 (Suppl. 2), 511–534 (1972)
Polak, J.M., Bloom, S.R., Adrian, T.E., Heitz, P., Bryant, M.G., Pearse, A.G.E.: Pancreatic polypeptide in insulinomas, gastrinomas, VIPomas and glucagonomas. Lancet 1, 328–330 (1976)
Rehfeld, J.F.: Disturbed islet cell function related to endogenous gastrin release. Studies on insulin secretion and glucose tolerance in pernicious anemia. J. Clin. Invest. 58, 41–49 (1976)
Rehfeld, J.F., Lauritsen, K.B., Stadil, F.: Insulin secretion in the Zollinger-Ellison syndrome. Scand. J. Gastroent. (Suppl.) 37, 63–66 (1976)
Robb, P.: The development of the islets of Langerhans in the human foetus. Quart. J. Exp. Physiol. 46, 335–343 (1961)
Sternberger, L.A.: Immunocytochemistry. Englewood Cliffs, N.J.: Prentice Hall Inc 1974
Sundler, F., Håkanson, R., Lundquist, I., Larsson, L.I.: Effect of alloxan on rat pancreatic polypeptide (PP) cells. Cell Tiss. Res. 178, 307–312 (1977)
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Larsson, LI. Two distinct types of islet abnormalities associated with endocrine pancreatic tumours. Virchows Arch. A Path. Anat. and Histol. 376, 209–219 (1977). https://doi.org/10.1007/BF00432397
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DOI: https://doi.org/10.1007/BF00432397