Malignant Pancreatic Somatostatinoma in a Patient with Dermatitis herpetiformis and Coeliac Disease

Levi, S; Bjarnason, Ingvar; Swinson, C M; Polak, J.M.; Murray, W R; Levi, A J

doi:10.1159/000199601

Cited by 10 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…About 40 cases of somatostatinoma has been reported since 1979 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), however, amy¬ loid in somatostatinomas has rarely been observed (18). Amyloid deposits in the pancreas from NIDDM patients and in insulinomas were recently seen to consist of islet amyloid polypeptide (IAPP) (2)(3)(4)(5)19,20).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Amyloid protein in somatostatinoma differs from human islet amyloid polypeptide

Ohsawa

Kanatsuka²,

Tokuyama³

et al. 1991

Acta Endocrinologica

View full text Add to dashboard Cite

Amyloid deposits in somatostatinomas are rare observations. To examine the characteristics of this amyloid, we compared amyloid deposits in a somatostatinoma to those found in pancreatic tissue in patients with Type II diabetes mellitus and in insulinomas, using immunohistochemical techniques and specific antibodies to islet amyloid polypeptide or other pancreatic hormones, as well as electron-microscopy. Antibodies to islet amyloid polypeptide regions 8-17 or 25-37 were confirmed to be specific. Amyloid deposits in patients with Type II diabetes mellitus and in insulinomas, but not those in the somatostatinoma strongly reacted with these antibodies, or to an antibody to amyloid P component. Amyloid deposits in the somatostatinoma were not reactive with antibodies to somatostatin or to other pancreatic hormones. Electron-microscopic examinations revealed that amyloid fibrils in the somatostatinoma were thinner and more randomly distributed than were those in islets from patients with Type II diabetes mellitus. As amyloid in somatostatinomas is unlike that consisting of islet amyloid polypeptide or other mature pancreatic hormones, it may be a novel type of local amyloid in pancreatic islets.Amyloid is a pathologic deposition of polymerized small proteins forming an anti-parallel ß-pleatedsheet conformation (1). There are various types of amyloid, and discrete fibril proteins were noted in case of different diseases. Insular amyloid deposits are common in Type II diabetes mellitus (NIDDM) and in insulinoma (2-5).Somatostatinoma is a rare somatostatin-secreting pancreatic islet cell tumour associated with diabetes mellitus (6-10). About 40 cases of somatostatinoma has been reported since 1979 (6-18), however, amy¬ loid in somatostatinomas has rarely been observed (18). Amyloid deposits in the pancreas from NIDDM patients and in insulinomas were recently seen to consist of islet amyloid polypeptide (IAPP) (2)(3)(4)(5)19,20). This peptide, also termed amylin (21,22), is a 37-amino acid peptide localized in se¬ cretory granules of B-cells in the normal cat pan¬ creas (23) and in the non-diabetic human pancreas (24,25). Analysis of the human IAPP gene (26) and of cDNA encoding IAPP (27,28) suggested that IAPP derives from pancreatic B-cells through proteolytic processing from an 89-amino acid precur¬ sor. However, characteristics of amyloid in soma¬ tostatinomas have not been elucidated.To investigate the characteristics of amyloid in somatostatinomas, we compared the immunoreactivities of amyloid deposits in a somatostatinoma with those in NIDDM pancreatic tissue and insuli¬ nomas, using immunohistochemical techniques and specific antibodies to IAPP and antibodies against other pancreatic hormones or amyloid P component. Fine structures of the amyloid fibrils were also compared electron-microscopically. Patients and Methods Somatostatinoma and insulinomaThe clinical characteristics of one patient with somatosta¬ tinoma and 5 with insulinoma are summarized in Table 1.

show abstract

mentioning

confidence: 99%

“…the somatostatinoma were not reactive with anti¬ bodies against IAPP, hCGRP 1, somatostatin, or other pancreatic hormones, thus this amyloid may not include these mature peptides. Because soma¬ tostatinoma with amyloid deposits has rarely been documented(18), compositional studies were not feasible. Therefore, these results should be viewed with caution.…”

mentioning

confidence: 99%

Amyloid protein in somatostatinoma differs from human islet amyloid polypeptide

Ohsawa

Kanatsuka²,

Tokuyama³

et al. 1991

Acta Endocrinologica

View full text Add to dashboard Cite

show abstract

“…Thirty-six cases were of pancreatic')-26) and 35 were of extra-pancreatic o~i g i n~~)~~~) . Most Manuscript received January 18,1990 : Accepted for publication March 23,1990. Address for reprint requests: Tadashi HACHISU, Department of Surgery, Sakura National Hospital, 2-36-2 Ebaradai, Sakura, Chiba, Japan.…”

Section: Introductionmentioning

confidence: 99%

A Case of Pancreatic Somatostatinoma Found Endoscopically with Metastasis to the Duodenal Periampulla

Matsunaga

Iwaoka

Tsubura

et al. 1990

Digestive Endoscopy

View full text Add to dashboard Cite

A case of pancreatic somatostatinoma with duodenal metastasis is reported. The presenting feature was severe right hypochondrial pain with cholecystolithiasis and mild diabetes mellitus. Duodenogastroscopy revealed a small polypoid lesion at the duodenal peri‐ampulla of the major papilla. A biopsy specimen demonstrated a neuroendocrine tumor. Selective gastroduodenal arteriography disclosed a spherical hypervascular lesion in the pancreaticoduodenal arcade. Pancreatoduodenectomy was performed and pathological examination demonstrated pancreatic islet cell tumor and metastasis to the duodenal peri‐ampulla. Immunocytochemical examinations demonstrated intra‐cytoplasmic somatostatin and calcitonin in both tumors. The patient's basal plasma somatostatin level was 4 times higher than the normal range, however her plasma calcitonin level was within the normal range. After the operation, plasma somatostatin levels were within the normal range and her clinical course was good. In this case endoscopy was very useful in detecting the early stage duodenal metastasis of pancreatic somatostatinoma.

show abstract