Skip to main content
SpringerLink
Log in

Endocrine neoplasms of the pancreas: A clinicopathologic study of 24 cases and immunohistochemical remarks

  • Original Articles
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

A total of 24 patients with endocrine neoplasms of the pancreas were clinicopathologically and immunohistochemically studied. They consisted of 18 patients with adenoma and 6 with carcinoma. Of the 24 patients, 13 developed attacks of hypoglycemia due to hyperinsulinemia, and 1 developed an uncontrollable duodenal ulcer caused by the hypersecretion of gastrin, however, the remaining 10 were asymptomatic. No prediction could be made as to the site of origin of the tumors. A clear difference was seen between adenoma and carcinoma in the size of the mass, the mean greatest diameter of the 18 adenoma cases being 1.7 cm, while that of the 6 carcinoma cases was 7.3cm. One of the 13 insulinomas and a gastrinoma was malignant, while all 24 tumors were positive for neuron-specific enolase. The 13 insulinomas were diffusely positive for insulin and 5 were also shown to be focally immunoreactive for gastrin, with 3 also being immunoreactive for somatostatin and 2 for pancreatic polypeptide. The gastrinoma showed immunoreactivity for somatostatin, insulin, pancreatic polypeptide, and glucagon in addition to a positivity to gastrin. The above findings thus indicate the multiple hormone synthesis of endocrine neoplasms of the pancreas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Creutzflet W (1980) Endocrine tumors of th pancreas: Clinical, chemical and morphological findings. In: Fitzgerald PJ, Morrison AB (eds) The pancreas. International Academy of Pathology Monograph No. 21, Williams & Wilkins, Baltimore, pp 208–230

    Google Scholar 

  2. Heitz PU (1984) Pancreatic endocrine tumours. In: Klöppel G, Heitz PU (ed) Pancreatic pathology. Churchill Livingstone, Edinburgh, pp 206–232

    Google Scholar 

  3. Cruickshank AH (1986) Tumours and hyperplasia of the endocrine pancreas. In: Cruickshank AH (ed) Pathology of the pancreas. Springer, Berlin Heidelberg New York, pp 155–180

    Google Scholar 

  4. Stefanini P, Carboni M, Patrassi N, Basc'i A (1974) Beta-islet cell tumors of the pancreas: Results of a study on 1,067 cases, Surgery 75:597–609

    Google Scholar 

  5. Liu TH, Tseng HC, Zhu Y, Zhong SX, Chen J, Cui QC (1985) Insulinoma: An immunocytochemical and morphologic analysis of 95 cases. Cancer 56:1420–1429.

    Google Scholar 

  6. Heitz PU, Kasper M, Polak JM, Klöppel G (1982) Pancreatic endocrine tumors: Immunocytochemical analysis of 125 tumors. Hum Pathol 13:263–271

    Google Scholar 

  7. Lopez-Kruger R, Dockerty MB (1947) Tumors of the islets of Langerhans. Surg Gynecol Obstet 85:495–511.

    Google Scholar 

  8. Cubilla AL, Hajdu SI (1975) Islet cell carcinoma of the pancreas. Arch Pathol 99:204–207

    Google Scholar 

  9. Mukai K, Greider MH, Grotting JC, Rosai J (1982) Retrospective study of 77 pancreatic endocrine tumors using the immunoperoxidase method. Am J Surg Pathol 6:387–399

    Google Scholar 

  10. Creutzfelt W (1977) Endocrine tumor of the pancreas. In: Volk BK, Wellmann KF eds. The Diabetic pancreas, Plenum Press, New York 551–590

    Google Scholar 

  11. Creutzfelt W (1980) Endocrine tumors of the pancreas: Clinical, chemical and morphological findings. In: Fitzgerald PJ, Morrison AB eds. The pancreas. Baltimore: William & Wilkins 208–230

    Google Scholar 

  12. Kahn CR, Rosen SW, Weintraub BD, Fajans SS, Gorden P (1977) Ectopic production of chorionic gonadotropic and its subunits by islet-cell tumors: A specific marker for malignancy. N Engl J Med 297:565–569

    Google Scholar 

  13. Schmechel D, Marangos PJ, Brightman M (1978) Neuronspecific enolase is a molecular marker for peripheral and central neuroendocrine cells. Nature 276:834–836

    Google Scholar 

  14. Tapia FJ, Polak JM, Barbosa AJA, Bloom SR, Marangos PJ, Dermody C (1981) Neuron-specific enolase is produced by neuroendocrine tumours. Lancet 1:808–811

    Google Scholar 

  15. Chejfec G, Falkmer S, Grimelius L, Jacobsson B, Rodensjö M, Wiedenmann B, Franke WW, Lee I, Gould VE (1987) Synaptophsin: A new marker for pancreatic neuroendocrine tumors. Am J Surg Pathol 11:241–247

    Google Scholar 

  16. Gould VE, Wiedenmann B, Lee I, Schwechheimer K, Dockhorn-Dworniczak B, Radosevich JA, Moll R, Franke WW (1987) Synaptophysin expression in neuroendocrine neoplasms as determined by immunocytochemistry. Am J Pathol 126:243–257

    Google Scholar 

  17. Miettinen M (1987) Synaptophysin and neurofilament proteins as markers for neuroendocrine tumors. Arch Pathol Lab Med 111:813–818

    Google Scholar 

  18. Gould VE (1987) Synaptophysin: A new and promising panneuroendocrine marker. Arch Pathol Lab Med 11:791–794

    Google Scholar 

  19. Sloane JP, Ormerod G (1981) Distribution of epithelial membrane antigen in normal and neoplastic tissues and its value in diagnostic tumor pathology. Cancer 47:1786–1795

    Google Scholar 

  20. Moll R, Franke WW, Schiller DL, Geiger B, Krepler R (1982) The catalogue of human cyto-keratins: Patterns of expression in normal epithelia, tumors, and cultured cells. Cell 31:11–24

    Google Scholar 

  21. Coopper D, Schermer A, Sun TT (1985) Classification of human epithelia and their neoplasms using monoclonal antibodies to keratins: Strategies, applications, and limitations. Lab Invest 52:243–256

    Google Scholar 

  22. Nathrath WBJ, Heidenkummer P, Björklund V, Björklund B (1985) Distribution of tissue polypeptide antigen (TPA) in normal human tissues: Immunohistochemical study on unfixed, methanol-, ethanol-, and formalin-fixed tissues. J Histochem Cytochem 33:99–109

    Google Scholar 

  23. Stabile BE, Braunstein GD, Passaro E (1980) Serum gastrin and human chorionic gonadotropin in the Zollinger-Ellison syndrome. Arch Surg 115:1090–1095

    Google Scholar 

  24. Blackman MR, Weintraub BD, Rosen SW, Kourides IA, Steinwascher K, Gall MH (1980) Human placental and pituitary glycoprotein hormones and their subunits as tumor markers: A quantitative assessment. J Natl Cancer Inst 65:81–93

    Google Scholar 

  25. Heitz PU, Kasper M, Klöppel G, Polak JM, Vaitukaitis JL (1983) Glycoprotein-hormone alpha-chain production by pancreatic endocrine tumors: A specific marker for malignancy. Immunocytochemical analysis of tumors of 155 patients. Cancer 51:277–282

    Google Scholar 

  26. O'Neal LW, Kipnis DM, Luse SA, Lacy PE, Jarett L (1968) Secretion of various endocrine substances by ACTH-secreting tumors — Gastrin, melanotropin, norepinephrine, serotonin, parathormone, vasopressin, glucagon. Cancer 21:1219–1232

    Google Scholar 

  27. Bordi C, Bussolati G (1974) Immunofluorescence, histochemical and ultrastructural studies for the detection of multiple endocrine polypeptide tumours of the pancreas. Virchows Arch [B] 17:13–27

    Google Scholar 

  28. Creutzfeldt W, Arnold R, Creutzfeldt C, Track NS (1975) Pathomorphologic, biochemical, and diagnostic aspects of gastrinomas (Zollinger-Ellison syndrome). Hum Pathol 6:47–76

    Google Scholar 

  29. Larsson LI, Grimelius L, Hakanson R, Rehfeld JF, Stadil F, Holst J, Angervall L, Sundler F (1975) Mixed endocrine pancreatic tumors producing several peptide hormones. Am J Pathol 79:271–284

    Google Scholar 

  30. Ladanyi M, Mulay S, Arseneau J, Bettez P (1987) Estrogen and progesterone receptor determination in the papillary cystic neoplasms of the pancreas: With immunohistochemical and ultrastructural observations. Cancer 60:1604–1611

    Google Scholar 

  31. Grieder MH, Rosai J, McGuigan JE (1974) The human pancreatic islet cells and their tumors. II. Ulcerogenic and diarrheogenic tumors. Cancer 33:1423–1443

    Google Scholar 

  32. Jones RA, Dawson IMP (1977) Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus, and their possible significance. Histopathology 1:137–150

    Google Scholar 

  33. Kruseman ACN, Knijnenburg G, Rivier GBDL, Bosman FT (1978) Morphology and immunohistochemically-defined endocrine function of pancreatic islet cell tumours. Histopathology 2:389–399

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Second Department of Pathology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812, Fukuoka, Japan

    Koji Yamaguchi & Munetomo Enjoji

  2. First Department of Surgery, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812, Fukuoka, Japan

    Koji Yamaguchi

Authors
  1. Koji Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Munetomo Enjoji
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamaguchi, K., Enjoji, M. Endocrine neoplasms of the pancreas: A clinicopathologic study of 24 cases and immunohistochemical remarks. Surg Today 22, 305–312 (1992). https://doi.org/10.1007/BF00308737

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00308737

Key Words

Search

Navigation