Endocrine Pathology for Medical II Students

Lab 1.h Pancreatic Endocrine Neoplasms

Tumors of the islet cells are called pancreatic endocrine neoplasms. These tumors are very rare, in comparison with tumors of the exocrine pancreas. They can elaborate pancreatic hormones or can be non-functional. They may be benign or malignant.

The most common pancreatic endocrine neoplasms are: 1) insulinoma; 2) gastrinoma (Zollinger-Ellison syndrome); and 3) associated with multiple endocrine neoplasia type I (MEN I).

Other rare pancreatic endocrine neoplasms include:

  • Glucagonoma (high plasma glucagon levels): mild diabetes mellitus, skin rash (necrolytic migratory erythema), and anemia;

  • Somatostatinoma (high plasma somatostatin levels): diabetes mellitus, cholelithiasis, steatorrhea, hypochlorhydria;

  • VIPoma (high plasma VIP levels): WDHA syndrome = watery diarrhea, hypokalemia, achlorhydria.

Slides 1.25 & 1.26

Slide 1.25

This is a partial pancreatectomy for a pancreatic endocrine neoplasm. The mass is well-circumscribed, red-brown, and solid. Pancreatic endocrine neoplasms can be solitary or multiple.

 pancreas
   

Slide 1.26

This is a microscopic image of an insulinoma, the most common of all pancreatic endocrine neoplasms. Tumor cells are very monotonous, growing in cords or acini, with a very rich capillary network, features characteristic of neuroendocrine neoplasms in general. Note the present of amorphous pink material (amyloid), a characteristic feature of insulinomas. Tumor produces excessive insulin, resulting in episodes of hypoglycemia. 90% of insulinomas are benign. It is difficult to predict the behavior of a pancreatic endocrine neoplasm from morphology alone. Features that indicate a malignant behavior are: presence of metastases, vascular invasion, or local infiltration.

pancreas

Digital Legends for Labs
Lab 1 Images
1-2 | 3-6 | 14-15 | 16-18 | 19-21 | 22 | 23-24 | 25-26
Lab 2 Images
1-3 | 7-8 | 9-11 | 12-14 | 15-18 | 19-20 | 21-22

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Updated November 4, 2009