Quantitative ultrastructure of endocrine cells of oxyntic mucosa in Zollinger-Ellison syndrome

D’Adda, Tiziana; Corleto, Vito D.; Pilato, Francesco Paolo; Baggi, Maria Teresa; Robutti, F; Fave, Gianfranco Delle; Bordi, Cesare

doi:10.1016/0016-5085(90)91224-t

Cited by 74 publications

(44 citation statements)

References 23 publications

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“…There are a few reports on ultrastructural investigations in patients with argyrophil cell hyperplasia demonstrating that endocrine proliferation in the oxyntic stomach mainly consists of ECL cells [1, 3, 32, 33]. In accordance, the present study using VMAT2 as a marker indicates that all forms of argyrophil cell hyperplasia in patients with CAG and ZES are constituted of ECL cells.…”

Section: Discussionsupporting

confidence: 89%

Expression of Vesicular Monoamine Transporters in Endocrine Hyperplasia and Endocrine Tumors of the Oxyntic Stomach

Eissele

Anlauf²,

Schäfer³

et al. 1999

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Background: Gastric enterochromaffin-like (ECL) cells selectively express the vesicular monoamine transporter (VMAT) VMAT2, and enterochromaffin (EC) cells the VMAT1 isoform. Aims: We investigated whether VMAT isoform selection indicates the origin of endocrine hyperplasia and neoplasia from oxyntic ECL or EC cells and may be of prognostic significance in different types of gastric carcinoids. Methods: Tissue from patients with chronic atrophic gastritis (CAG), Zollinger-Ellison-syndrome (ZES), gastric carcinoids and neuroendocrine carcinoma (NEC) was investigated by immunohistology and in situ hybridization. Results: Endocrine cells forming diffuse, linear, and micronodular hyperplasia in CAG and ZES, as well as oxyntic microcarcinoids expressed both VMAT2 and chromogranin A (CgA) but neither VMAT1 nor serotonin. In five of six sporadic carcinoids VMAT2 and CgA but not VMAT1 were detected. One carcinoid was copositive for VMAT1 and serotonin but negative for VMAT2. Electron microscopy confirmed the VMAT2-positive tumors as ECLoma and the VMAT1-immunoreactive carcinoid as EComa. Conclusions: VMAT2 and VMAT1 are reliable markers for differentiation of gastric endocrine hyperplasia and neoplasia from ECL and EC cells, respectively. The significance of VMAT2 and VMAT1 as prognostic markers lies in the relatively poor prognosis for EComa compared to ECLoma, characterized by VMAT2 positivity. The absence of both VMAT2 and VMAT1 in NEC may indicate poor prognosis.

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Section: Discussionsupporting

confidence: 89%

Expression of Vesicular Monoamine Transporters in Endocrine Hyperplasia and Endocrine Tumors of the Oxyntic Stomach

Eissele

Anlauf²,

Schäfer³

et al. 1999

Digestion

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“…Increased CgA concentrations were detected, however, in all of our patients with gastrinoma, although they all had a very limited tumor burden. It is well known that chronic elevation of gastrin levels provokes hyperplasia of the neuroendocrine cells of the stomach (13). As these cells are able to secrete CgA, they might be responsible for the elevated CgA concentrations.…”

Section: Discussionmentioning

confidence: 99%

Chromogranin A as Serum Marker for Neuroendocrine Neoplasia: Comparison with Neuron-Specific Enolase and the -Subunit of Glycoprotein Hormones

Nobels¹

1997

Journal of Clinical Endocrinology & Metabolism

199

202

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Chromogranin A (CgA) is gaining acceptance as a serum marker of neuroendocrine tumors. Its specificity in differentiating between neuroendocrine and nonneuroendocrine tumors, its sensitivity to detect small tumors, and its clinical value, compared with other neuroendocrine markers, have not clearly been defined, however. The objectives of this study were to evaluate the clinical usefulness of CgA as neuroendocrine serum marker. Serum levels of CgA, neuron-specific enolase (NSE), and the ␣-subunit of glycoprotein hormones (␣-SU) were determined in 211 patients with neuroendocrine tumors and 180 control subjects with nonendocrine tumors. The concentrations of CgA, NSE, and ␣-SU were elevated in 50%, 43%, and 24% of patients with neuroendocrine tumors, respectively. Serum CgA was most frequently increased in subjects with gastrinomas (100%), pheochromocytomas (89%), carcinoid tumors (80%), nonfunctioning tumors of the endocrine pancreas (69%), and medullary thyroid carcinomas (50%). The highest levels were observed in subjects with carcinoid tumors.

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“…In clinical practice, the most common causes of false-positive results are the use of proton pump inhibitors and cases of atrophic gastritis. Lack of gastric acid leads to hypergastrinaemia due to loss of negative feedback for gastrin, and this chronic elevation of gastrin levels provoke hyperplasia of the neuroendocrine cells of the stomach, which are able to secrete CgA (32). Proton pump inhibitor (PPI) therapy may increase CgA concentration just five days after first intake, so this drug should be discontinued at least 14 days before the test (33), and possibly 3 weeks is the safest.…”

Section: Diagnosis: Proposed Algorithmmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Flushing: current concepts

Huguet

Grossman

2017

European Journal of Endocrinology

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Objective: Flushing can be defined as a sensation of warmth accompanied by erythema that most commonly is seen on the face and which occurs in episodic attacks. Such a problem can be clinically problematic, since many conditions and drugs can be related to flushing, and while often there appears to be no underlying organic disease, it is important to exclude disorders since they may be life-threatening conditions. Design and methods: We performed a search in MEDLINE using the terms 'flushing' in combination with 'carcinoid syndrome', 'pheochromocytoma', 'mastocytosis', 'menopausal hot flush' and 'treatment'. European and American guidelines relating to neuroendocrine tumours, mastocytosis and menopause were reviewed. Results: In this review, we discuss the main causes of flushing and propose an algorithm based on pathogenesis, which can be used to guide the clinical evaluation process. We also review recent significant developments in the assessment and treatment of the carcinoid syndrome and menopausal hot flushes, which should guide the clinical practice regarding this common but sometimes confusing condition. Conclusions: When evaluating flushing, a precise systematic approach is needed to exclude potentially serious underlying causes, although despite this, the cause of the disorder is not always found. If symptoms are not progressive, the patient should be advised about its apparently benign nature in order to avoid unnecessary studies or initiating treatments of minimal benefit.

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Quantitative ultrastructure of endocrine cells of oxyntic mucosa in Zollinger-Ellison syndrome

Cited by 74 publications

References 23 publications

Expression of Vesicular Monoamine Transporters in Endocrine Hyperplasia and Endocrine Tumors of the Oxyntic Stomach

Expression of Vesicular Monoamine Transporters in Endocrine Hyperplasia and Endocrine Tumors of the Oxyntic Stomach

Chromogranin A as Serum Marker for Neuroendocrine Neoplasia: Comparison with Neuron-Specific Enolase and the -Subunit of Glycoprotein Hormones

MANAGEMENT OF ENDOCRINE DISEASE: Flushing: current concepts

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