Insulinoma pathophysiology
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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
Pathophysiology
Genetics
- Insulinoma can occur in association with inherited syndrome, such as multiple endocrine neoplasia type 1 von Hippel-Landau 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
- Endocrine cells in insulinoma are organised in nests and trabecular pattern scattered throughout a fibro-vascular stroma with well-localised fibrous septa separating it from normal tissue[3]
- Absence of exocrine tissue with the loss of normal pancreatic architecture
-
![Histopathology of pancreatic endocrine tumor (insulinoma). H&E stain[4]](/images/2/2d/Pancreatic_insulinoma_Histology_1.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma). H&E stain[4] -
![Histopathology of pancreatic endocrine tumor (insulinoma)[4]](/images/2/2f/Pancreatic_insulinoma_histology_2.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma)[4] -
![Histopathology of pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain[4]](/images/a/a3/Pancreatic_insulinoma_histopathology_3.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain[4] -
![Histopathology of pancreatic endocrine tumor (insulinoma). Insulin immunostain[4]](/images/d/d5/Pancreatic_insulinoma_histology_4.JPG)
Histopathology of pancreatic endocrine tumor (insulinoma). Insulin immunostain[4]
![Histopathology of pancreatic endocrine tumor (insulinoma). H&E stain[4]](/index.php/File:Pancreatic_insulinoma_Histology_1.JPG)
![Histopathology of pancreatic endocrine tumor (insulinoma)[4]](/index.php/File:Pancreatic_insulinoma_histology_2.JPG)
![Histopathology of pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain[4]](/index.php/File:Pancreatic_insulinoma_histopathology_3.JPG)
![Histopathology of pancreatic endocrine tumor (insulinoma). Insulin immunostain[4]](/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
- ↑ Narita M, Kimura K, Tanimura N, Arai S, Tsuboi T, Katsuda K (2000). "Immunohistochemical characterization of calf pneumonia produced by the combined endobronchial administration of bovine herpesvirus 1 and Pasteurella haemolytica". J Comp Pathol. 123 (2–3): 126–34. doi:10.1053/jcpa.2000.0402. PMID 11032665.
- ↑ 4.0 4.1 4.2 4.3 Neuroendocrine tumour of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas