Demonstration of Glucagon in Islet Cell Adenomas of the Pancreas by Immunofluorescent Technic

Lomský, R; Langr, F; Vortel, V

doi:10.1093/ajcp/51.2.245

Cited by 33 publications

(6 citation statements)

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“…Most proven gastrinomas in which the staining reactions are recorded have argyrophil granules (Cavallero, Solcia & Sampietro 1967, Royston, Brew, Garnham, Stagg & Polak 1972, Creutzfeldt et al 1975), but again it has been suggested that granules in tumour cells do not necessarily stain as, or show the immunological reactions of their normal counterparts (Schulte et al 1969, Vassallo et al 1972) and Greider, Steinberg & McGuigan (rg72) have failed to correlate argyrophilia with positive immunofluorescence for gastrins. Glucagonomas have been generally described as argyrophil and immunologically identifiable (McGavran, Unger, Recant, Polk, Kilo & Levin 1966, Lomsky, Langr & Vortel 1969, Croughs, Huismans, Israel, Hackerg & Schopman 1972. Both of our immunologically proven glucagonomas were argyrophil, but were also well differentiated; we do not know how an anaplastic tumour would behave immunoIogicalIy or tinctorially.…”

Section: Discussionmentioning

confidence: 66%

Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus and their possible significance

Jones

Dawson

1977

Histopathology

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We have studied 109 endocrine cell tumours of the gastrointestinal tract, pancreas and bronchus in terms of histological pattern and histochemical staining with immunocytochemical studies on seven tumours. As a result we believe that previous histological classifications need modification. 5-Hydroxytryptamine secreting tumours have a carcinoid (A1) pattern with, in some cases, an additional tubuloacinar element (A1A2) and definable histochemical reactions; well differentiated gastrinomas, insulinomas and glucagonomas are associated commonly, but not exclusively, with particular histological patterns and argyrophilia, but no such association exists for less differentiated tumours. This may be related to the synthesis of precursor hormones by less differentiated tumours. Mixed patterns are common, particularly in tumours of foregut derivation. Prospective studies planned to correlate histology, histochemistry, immunocytochemistry and ultrastructure are needed on all endocrine cell tumours.

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Section: Discussionmentioning

confidence: 66%

Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus and their possible significance

Jones

Dawson

1977

Histopathology

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“…Of 60 cases in which tumor site was recorded, 30 (50%) appeared confined to the region of the tail (5,7,13,15,18,20,24,35,37,50,52,65,66,(71)(72)(73)(74)(75)(76)(77)(78)(79)(80), whereas tumors of the head or neck (4,13,21,37,73,81,82), body (13,18,(83)(84)(85)(86)(87), and body-tail region (3,28,33,68,89,90) were less frequently described. In seven cases multiple tumors (91) or diffuse involvement by a single mass (6,10,32,51,88,92) precluded specific localization of th...…”

Section: Location and Sizementioning

confidence: 99%

“…It is probable that the persistent hyperglycemia in glucagonoma patients reflects the interplay between glucagon and insulin levels on carbohydrate metabolism. Plasma insulin concentrations may be normal (15,20,50) or elevated (24,28,34,35,51,65,67,72,77,78,79,91). There is no correlation, however, between circulating insulin and glucagon levels.…”

Section: Hyperglycemiamentioning

confidence: 99%

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The Glucagonoma Syndrome: Clinical Features, Diagnosis, and Treatment

1981

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Historical BackgroundIslet cell tumors of the pancreas have been described for over 50 yr. Although carcinoma arising from islet tissue had been noted since the turn of the century (1), not until 1927 was the first case of a hormonally active pancreatic neoplasm, an insulinoma, recorded (2). For many years thereafter, pancreatic endocrine tumors were characterized as either insulin-producing or "nonfunctional," the latter being derived from cells apparently devoid of clinically significant hormonal activity. With time, however, other islet cell secretory products were discovered and their tumors identified with various clinical syndromes. Whereas the hypoglycemia of insulinomas and hyperacidity of gastrinomas figured prominently in the initial recognition of these neoplasms, the clinical signs of glucagon-producing tumors were less readily apparent and not as easily attributable to specific hormone excess.Becker and co-workers (3) are credited with the first description of a glucagonoma. Their case, reported in 1947 but diagnosable only in retrospect, typifies what is now regarded as a classic clinical presentation of the syndrome. The patient, a 45-yr-old woman, sought attention because of a skin rash that, over a period of 8 months, progressed to involve almost her entire body. Weight loss, weakness, and amenorrhea were additional complaints. The rash was symmetrically distributed and characterized by confluent, pruritic areas of macular, erythematous, and vesicular erruptions showing evidence of exfoliation and superficial necrosis. Stomatitis and onchonolysis were also found. Laboratory examination revealed a normochromic anemia, mild fasting hyperglycemia, and hypoproteinemia. Deep venous thrombosis developed while the patient was in hospital, and she succumbed to cardiorespiratory failure. At autopsy, an islet cell neoplasm was discovered "replacing the body

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“…In addition to tumors associated with the glucagonoma syndrome, other glucagon-cell tumors have been described. 6 " 8 These tumors are sometimes associated with multiple endocrine adenomatosis 9 ' 10 and are usually found by chance, as they are present in patients with endocrine syndromes unrelated to glucagon secretion. 9 Despite the number of morphologic studies dealing with other endocrine cell neoplasms of the pancreas, including those associated with hypoglycemic-hyperinsulinemic, 11 " 15 ulcerogenic, 13 " 18 and diarrheogenic 15 " 17 syndromes, morphology of glucagonomas, with the exception of single case reports, has not received comparable attention.…”

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confidence: 99%

A Study of Glucagonomas by Light and Electron Microscopy and Immunofluorescence

et al. 1979

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Five tumors associated with the complete glucagonoma syndrome, as well as a series of glucagon-cell adenomas from three patients without this syndrome, were investigated by light and electron microscopy and by immunofluorescence. All tumors associated with the syndrome were large, from 3 to 35 cm along the major axis, and three of them were proved to be malignant. No common histologic arrangement of tumor cells was apparent for the five neoplasms examined. Immunofluorescent staining for glucagon and glicentin was carried out: while most cells were negative, a varying number of scattered cells were positive with both antisera in all tumors except one; three tumors contained more glicentin- than glucagon-immunoreactive cells. Moreover, three tumors were multihormonal, witn cells positive for pancreatic polypeptide and/or insulin. Ultrastructurally, the secretory granules of cells from these tumors were not typical of those found in A-cells from adult human islets. The glucagon-cell tumors from patients without the syndrome were benign, usually multiple, and were small, with diameters from 0.5 mm to 1 cm. In most cases, the cells from these neoplasms arranged in a characteristic pattern (ribbonlike or "gyriform"). In most tumors, the majority of cells showed both glucagon and glicentin immunofluorescence and the ultrastructural appearance of their secretory granules was similar to that of normal islet A-cells. From the morphologic point of view, therefore, cells from tumors not associated with the glucagonoma syndrome resemble normal glucagon cells more closely than those from tumors associated with the syndrome.

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Demonstration of Glucagon in Islet Cell Adenomas of the Pancreas by Immunofluorescent Technic

Cited by 33 publications

References 5 publications

Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus and their possible significance

Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus and their possible significance

The Glucagonoma Syndrome: Clinical Features, Diagnosis, and Treatment

A Study of Glucagonomas by Light and Electron Microscopy and Immunofluorescence

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