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.
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Heitz PU, Kasper M, Polak JM, Kloeppel G: Pancreatic endocrine tumors. Immunocytochemical analysis of 125 tumors. Hum Pathol 13:263–271, 1982
Erlandsen SL: Types of pancreatic islet cells and their immunocytochemical identification.In The Pancreas. PJ Fitzgerald, AB Morrison (eds). Baltimore, Williams & Wilkins, 1980, pp 140–155
Moldow RE, Connelly RR: Epidemiology of pancreatic cancer in Connecticut. Gastroenterology 55:677–686, 1968
Frantz VK: Islet cell tumors.In Tumor of the Pancreas. VK Frantz (ed). Washington, DC, AFIP, 1959, pp 79–141
Becker V: Pathologisch-anatomische Aspekte bei endokrin wirksamen Tumoren. Langenbecks Arch Klin Chir 329:426–437, 1971
Warren S, LeCompte PM, Legg MA: The Pathology of Diabetes Mellitus, 4th ed. Philadelphia, Lea & Febiger, 1966
Nicholls AG: Simple adenoma of the pancreas arising from an island of Langerhans. J Med Res 8:358–395, 1902
Pappenheimer: Quote, by Wipple AO, Frantz VK: Adenoma of islet cell with hyperinsulinism. Ann Surg 101:1299–1335, 1935
Lopez-Kruger R, Dockerty MB: Tumors of the islets of Langerhans. Surg Gynecol Obstet 85:495–511, 1947
Korpassy B: Die Basalzellenmetaplasie der Ausfuhrungsgange des Pankreas. Virchows Arch Abt A Pathol Anat 303:359–373, 1939
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, 1975
Warren S: Adenomas of the islands of Langerhans. Am J Pathol 2:335–340, 1926
Laidlaw GF: Nesidioblastoma, the islet tumor of the pancreas. Am J Pathol 14:125–134, 1938
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 208–230
Creutzfeldt W, Arnold R, Creutzfeldt C, Track NS: Pathomorphologic, biochemical, and diagnostic aspects of gastrinomas (Zollinger-Ellison syndrome). Hum Pathol 6:47–76, 1975
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, 1989
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, 1989
Nakane P, Kawaoi A: Peroxidase labeled antibody: A new method of conjugation. J Histochem Cytochem 22:1084–1091, 1974
Diamandopoulos Gth, Meissner WA: Neoplasia:IN Anderson's Pathology, Vol 1, 8th ed. JM Kissane (ed). St. Louis, CB Mosby, 1985, pp 514–559
Burkhardt L: Inselneubildung im Pankreas bei Stenose des Ausfuhrungsganges durch Pancreaskopfcarcinom. Virchows Arch 20:655–665, 1935
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, 1960
Bartow SA, Mukai K, Rosai J: Pseudoneoplastic proliferation of endocrine cells in pancreatic fibrosis. Cancer 47:2627–2633, 1981
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 556–620
Reid JD, Yuh SL, Petrelli M, Jaffe R: Ductuloinsular tumors of the pancreas: A light, electron microscopic and immunohistochemical study. Cancer 49:908–915, 1982
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, 1989
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, 1982
Tomita T, Bhatia P, Gourley W: Mucin producing islet cell adenoma. Hum Pathol 12:850–853, 1981
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, 1975
Polak JM, Bloom SR, Adrian TE, Heitz P, Bryant MG, Pease AGE: Pancreatic polypeptide in insulinomas, gastrinomas, VIPomas, and glucagonomas. Lancet 14:328–330, 1976
Broder LE, Carter SK: Pancreatic islet cell carcinoma. 1 Clinical features of 52 patients. Ann Intern Med 79:101–107, 1973
Cubilla AL, Hajdu SI: Islet cell carcinoma of the pancreas. Arch Pathol 99:204–207, 1975
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 749–896
Sieracki J, Marshall RB, Horn RC: Tumors of the pancreatic islets. Cancer 13:347–357, 1960
Creutzfeldt W, Arnold R: Endocrine tumors of the pancreas.In Bockus Gastroenterology 4th ed. JE Beak (ed) Philadelphia, WB Saunders, 1985, pp 4122–4144
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Kimura, W., Kuroda, A. & Morioka, Y. Clinical pathology of endocrine tumors of the pancreas. Digest Dis Sci 36, 933–942 (1991). https://doi.org/10.1007/BF01297144
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DOI: https://doi.org/10.1007/BF01297144