Insulinoma pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
On microscopic histopathological analysis, solid or gyriform patterns, usually without glands are characteristic findings of insulinoma. Genes involved in the pathogenesis of carcinoid tumor are MEN1 and | |||
==Pathophysiology== | ==Pathophysiology== | ||
An insulinoma is a tumor of the pancreas that is derived from beta cells and secretes insulin. It is a rare form of a neuroendocrine tumor. Most insulinomas are benign in that they grow exclusively at their origin within the pancreas, but a minority metastasize. Insulinomas are one of the functional pancreatic neuroendocrine tumor ("functional" because it increases production of insulin). Beta cells secrete insulin in response to increases in blood glucose. The resulting increase in insulin acts to lower blood glucose back to normal levels at which point further secretion of insulin is stopped. In contrast, the secretion of insulin by insulinomas is not properly regulated by glucose and the tumors will continue to secrete insulin causing glucose levels to fall further than normal. | An insulinoma is a tumor of the pancreas that is derived from beta cells and secretes insulin. It is a rare form of a neuroendocrine tumor. Most insulinomas are benign in that they grow exclusively at their origin within the pancreas, but a minority metastasize. Insulinomas are one of the functional pancreatic neuroendocrine tumor ("functional" because it increases production of insulin). Beta cells secrete insulin in response to increases in blood glucose. The resulting increase in insulin acts to lower blood glucose back to normal levels at which point further secretion of insulin is stopped. In contrast, the secretion of insulin by insulinomas is not properly regulated by glucose and the tumors will continue to secrete insulin causing glucose levels to fall further than normal. | ||
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==Microscopic Pathology== | ==Microscopic Pathology== | ||
On microscopic histopathological analysis characteristic findings of insulinoma are: | On microscopic histopathological analysis characteristic findings of insulinoma are: | ||
*Solid or gyriform patterns, usually without glands | *Solid or gyriform patterns, usually without glands | ||
Revision as of 20:16, 7 October 2015
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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]
Overview
On microscopic histopathological analysis, solid or gyriform patterns, usually without glands are characteristic findings of insulinoma. Genes involved in the pathogenesis of carcinoid tumor are MEN1 and
Pathophysiology
An insulinoma is a tumor of the pancreas that is derived from beta cells and secretes insulin. It is a rare form of a neuroendocrine tumor. Most insulinomas are benign in that they grow exclusively at their origin within the pancreas, but a minority metastasize. Insulinomas are one of the functional pancreatic neuroendocrine tumor ("functional" because it increases production of insulin). Beta cells secrete insulin in response to increases in blood glucose. The resulting increase in insulin acts to lower blood glucose back to normal levels at which point further secretion of insulin is stopped. In contrast, the secretion of insulin by insulinomas is not properly regulated by glucose and the tumors will continue to secrete insulin causing glucose levels to fall further than normal.
Genetics
- Insulinoma can occur in association with inherited syndrome, such as multiple endocrine neoplasia type 1, von Hippel-Lindau syndrome or sporadic.[1]
- Multiple endocrine neoplasia type 1 is an autosomal dominant disorder caused by alterations of the MEN1 gene located at chromosomal region 11q13.
- Approximately 10% of insulinomas are multiple and 10% malignant.[2]
Microscopic Pathology
On microscopic histopathological analysis characteristic findings of insulinoma are:
- Solid or gyriform patterns, usually without glands
-
![Histopathology of pancreatic endocrine tumor (insulinoma). H&E stain[3]](/images/2/2d/Pancreatic_insulinoma_Histology_1.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma). H&E stain[3] -
![Histopathology of pancreatic endocrine tumor (insulinoma)[3]](/images/2/2f/Pancreatic_insulinoma_histology_2.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma)[3] -
![Histopathology of pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain[3]](/images/a/a3/Pancreatic_insulinoma_histopathology_3.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain[3] -
![Histopathology of pancreatic endocrine tumor (insulinoma). Insulin immunostain[3]](/images/d/d5/Pancreatic_insulinoma_histology_4.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma). Insulin immunostain[3]
![Histopathology of pancreatic endocrine tumor (insulinoma). H&E stain[3]](/index.php/File:Pancreatic_insulinoma_Histology_1.JPG)
![Histopathology of pancreatic endocrine tumor (insulinoma)[3]](/index.php/File:Pancreatic_insulinoma_histology_2.JPG)
![Histopathology of pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain[3]](/index.php/File:Pancreatic_insulinoma_histopathology_3.JPG)
![Histopathology of pancreatic endocrine tumor (insulinoma). Insulin immunostain[3]](/index.php/File:Pancreatic_insulinoma_histology_4.JPG)
References
- ↑ Murray PD, McKenzie DT, Swain SL, Kagnoff MF (1987). "Interleukin 5 and interleukin 4 produced by Peyer's patch T cells selectively enhance immunoglobulin A expression". J Immunol. 139 (8): 2669–74. PMID 3498768.
- ↑ Insulinoma. Dr Yuranga Weerakkody and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/insulinoma
- ↑ 3.0 3.1 3.2 3.3 Neuroendocrine tumour of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas