Glucagonoma other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
Other diagnostic studies for glucagonoma include venous sampling after a selective injection of a stimulating [[secretin]]. Biopsy, which demonstrates epidermal necrosis, subcorneal pustules, either isolated or associated with necrosis of the epidermis, confluent [[parakeratosis]], epidermal hyperplasia and marked papillary dermal angioplasia, and suppurative folliculitis. | Other diagnostic studies for glucagonoma include [[Venous blood|venous sampling]] after a selective injection of a stimulating [[secretin]]. [[Biopsy]], which demonstrates epidermal [[necrosis]], subcorneal [[pustules]], either isolated or associated with [[necrosis]] of the [[epidermis]], confluent [[parakeratosis]], epidermal [[hyperplasia]] and marked papillary dermal angioplasia, and [[suppurative]] [[folliculitis]]. | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
Invasive investigations may be needed to localize tumors at particular regions of the pancreas for treatment planning. | Invasive investigations may be needed to localize [[tumors]] at particular regions of the [[pancreas]] for treatment planning. | ||
=== | === Arterial stimulation venous sampling === | ||
[[ | Transhepatic portal [[venous]] sampling involves a selective injection of a stimulating [[secretin]] for glucagonoma into [[arterial]] supply of the [[pancreas]] with a sampling of the [[hepatic vein|hepatic veins]]. It is highly [[Sensitivity (tests)|sensitive]].<ref name="pmid1984627">{{cite journal| author=Vinik AI, Delbridge L, Moattari R, Cho K, Thompson N| title=Transhepatic portal vein catheterization for localization of insulinomas: a ten-year experience. | journal=Surgery | year= 1991 | volume= 109 | issue= 1 | pages= 1-11; discussion 111 | pmid=1984627 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1984627 }}</ref><ref name="pmid1455303">{{cite journal| author=Thom AK, Norton JA, Doppman JL, Miller DL, Chang R, Jensen RT| title=Prospective study of the use of intraarterial secretin injection and portal venous sampling to localize duodenal gastrinomas. | journal=Surgery | year= 1992 | volume= 112 | issue= 6 | pages= 1002-8; discussion 1008-9 | pmid=1455303 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1455303 }}</ref> | ||
===Biopsy=== | ===Biopsy=== | ||
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* Findings on biopsy suggestive of glucagonoma include:<ref name="pmid3014912">{{cite journal| author=Kheir SM, Omura EF, Grizzle WE, Herrera GA, Lee I| title=Histologic variation in the skin lesions of the glucagonoma syndrome. | journal=Am J Surg Pathol | year= 1986 | volume= 10 | issue= 7 | pages= 445-53 | pmid=3014912 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3014912 }} </ref> | * Findings on biopsy suggestive of glucagonoma include:<ref name="pmid3014912">{{cite journal| author=Kheir SM, Omura EF, Grizzle WE, Herrera GA, Lee I| title=Histologic variation in the skin lesions of the glucagonoma syndrome. | journal=Am J Surg Pathol | year= 1986 | volume= 10 | issue= 7 | pages= 445-53 | pmid=3014912 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3014912 }} </ref> | ||
**Epidermal [[necrosis]] and [[hyperplasia]] | **Epidermal [[necrosis]] and [[hyperplasia]] | ||
** | **Parakeratosis | ||
**Subcorneal [[pustules]] | **Subcorneal [[pustules]] | ||
**[[Angioplasia|Papillary dermal angioplasia]] | **[[Angioplasia|Papillary dermal angioplasia]] | ||
| Line 23: | Line 23: | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Gastroenterology]] | |||
[[Category:Surgery]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2] Mohammed Abdelwahed M.D[3]
Overview
Other diagnostic studies for glucagonoma include venous sampling after a selective injection of a stimulating secretin. Biopsy, which demonstrates epidermal necrosis, subcorneal pustules, either isolated or associated with necrosis of the epidermis, confluent parakeratosis, epidermal hyperplasia and marked papillary dermal angioplasia, and suppurative folliculitis.
Other Diagnostic Studies
Invasive investigations may be needed to localize tumors at particular regions of the pancreas for treatment planning.
Arterial stimulation venous sampling
Transhepatic portal venous sampling involves a selective injection of a stimulating secretin for glucagonoma into arterial supply of the pancreas with a sampling of the hepatic veins. It is highly sensitive.[1][2]
Biopsy
- A skin biopsy may show necrolytic migratory erythema in patients with glucagonoma.
- Findings on biopsy suggestive of glucagonoma include:[3]
- Epidermal necrosis and hyperplasia
- Parakeratosis
- Subcorneal pustules
- Papillary dermal angioplasia
- Suppurative folliculitis
References
- ↑ Vinik AI, Delbridge L, Moattari R, Cho K, Thompson N (1991). "Transhepatic portal vein catheterization for localization of insulinomas: a ten-year experience". Surgery. 109 (1): 1–11, discussion 111. PMID 1984627.
- ↑ Thom AK, Norton JA, Doppman JL, Miller DL, Chang R, Jensen RT (1992). "Prospective study of the use of intraarterial secretin injection and portal venous sampling to localize duodenal gastrinomas". Surgery. 112 (6): 1002–8, discussion 1008-9. PMID 1455303.
- ↑ Kheir SM, Omura EF, Grizzle WE, Herrera GA, Lee I (1986). "Histologic variation in the skin lesions of the glucagonoma syndrome". Am J Surg Pathol. 10 (7): 445–53. PMID 3014912.