Neuroendocrine Differentiation in Pancreatic Duct Carcinoma Special Emphasis on Duct-Endocrine Cell Carcinoma of the Pancreas

Kamisawa, Terumi; Fukayama, Masashi; Tabata, I; Isawa, Tomoaki; Tsuruta, Kouji; Okamoto, A.; Koike,

doi:10.1016/s0344-0338(96)80071-9

Cited by 25 publications

(20 citation statements)

References 14 publications

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“…Other mixed tumours were reported for the oesophagus with neuroendocrine, squamous and glandular differentiation [17]. Kamisawa et al [18] described and defined neuroendocrine differentiation in pancreatic duct carcinomas occurring in a scattered and a diffuse form. In this particular case we observed all major characteristics of the panniculitis syndrome except eosinophilia and polyserositis.…”

Section: Discussionmentioning

confidence: 99%

Carcinoma of the Pancreas with Neuroendocrine Differentiation and Nodular Panniculitis

Berkovic¹,

Hallermann²

2003

Oncol Res Treat

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Background: On rare occasions tumours of the pancreas produce high amounts of pancreatic lipase. The enzyme activity in the blood and in different tissues causes a syndrome called nodular panniculitis by focal necrosis of lipids and a concomittant inflammatory reaction. Case Report: A 72-year-old man was admitted to the dermatology clinic with the diagnosis of erythema nodosum. The patient had been well until 3 months earlier when painful red nodes developed on the skin of both shanks. He complained of profuse night sweating and a weight loss of 10 kg within that time but did not have fever. He also had noticed a painful swelling of his right index finger, left middle finger and the third toe on his left foot. Biopsy of the nodes revealed a focal necrosis of fatty tissue. Laboratory examinations showed a highly elevated concentration of serum pancreatic lipase. Further investigations showed a tumour in the pancreas and several osteolytic lesions. Tumour biopsy revealed a neuroendocrine carcinoma. After tumour resection serum lipase level immediately fell to almost normal values, and all skin and bone manifestations disappeared quickly. Conclusion: Due to its clinical appearance the panniculitis syndrome is most often mistaken for either erythema nodosum or rheumatoid arthritis. A resection of the tumour after correct diagnosis should always be considered because the widespread manifestations in the skin and bones do not represent distant metastasis and have a very good chance to dissolve completely.

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Section: Discussionmentioning

confidence: 99%

Carcinoma of the Pancreas with Neuroendocrine Differentiation and Nodular Panniculitis

Berkovic¹,

Hallermann²

2003

Oncol Res Treat

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“…34 In addition, scattered neuroendocrine cells have been observed in some human pancreatic ductal adenocarcinomas, especially well-differentiated neoplasms. 35,36 DMBA tumors are usually well to moderately differentiated, and the presence of neuroendocrine cells correlates with the level of differentiation. Overall, neuroendocrine cells were observed infrequently and their role, if any, in the pathogenesis of these tumors remains to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

Immunohistochemical Characterization of Pancreatic Tumors Induced by Dimethylbenzanthracene in Rats

Jimenez

Z’graggen

Hartwig

et al. 1999

The American Journal of Pathology

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Chemical carcinogenesis using dimethylbenzanthracene (DMBA) has been shown to induce pancreatic tumors in rats with potential for local invasion and peritoneal metastases.1 Tumors produced show a duct-like phenotype reminiscent of pancreatic neoplasms in man. Moreover, surrounding pancreatic ducts display features of hyperplasia, dysplasia, and carcinoma in situ, suggesting a gradual transition from normal duct epithelium to invasive carcinoma.Despite the ductal phenotype of most human pancreatic carcinomas, there is still considerable debate as to the cell of origin of these tumors. Most adenocarcinomas are presumed to originate from ductal cells because they show mucin production, lack secretory granules, and have morphological features of ductal cells. However, cases of human ductal pancreatic neoplasms with prominent neuroendocrine and acinar differentiation have been described in the literature, suggesting a pluripotent cell of origin. 2,3Experimental rodent models of pancreatic carcinoma have also contributed to the existing debate. Duct-like cell lines have been derived from a transplantable acinar cell carcinoma induced by asazerine in rats. 4 The authors suggest that some pancreatic carcinomas with a ductal phenotype might result from transformation, dedifferentiation, and/or metaplasia of acinar cells. In a different model, islet cells have been implicated as cells of origin for pancreatic neoplasms induced by N-nitroso-bis(2-oxypropyl) amine (BOP) in Syrian female hamsters.5 Neoplastic duct-like complexes have been observed in the vicinity of islets of Langerhans in hamster pancreata exposed to BOP, suggesting a role for neuroendocrine cells in pancreatic tumorigenesis. These investigators have also observed differentiation of cultured islet cells into ductular and acinar cells and have used this information to explain their findings in BOP-induced tumors. 6 To further characterize DMBA pancreatic tumors in rats, we studied the pattern of expression of various ductal, acinar and islet cell markers in these lesions. Our goals were to determine whether DMBA tumors express markers consistent with a ductal phenotype, to determine whether tumor marker expression is consistent with hu-

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“…Scattered endocrine cells in pancreatic ductal adenocarcinomas have been widely reported to be either lined up along the base of the neoplastic glands or to lie between the neoplastic columnar cells [2,3,8,10,11,15,19,20,22]. They should be separated from endocrine cells in mixed ductal-endocrine carcinomas in which ductal and endocrine cells, which comprise at least one third to one half of tumor tissue, are intimately admixed in the primary tumors, as well as in their metastases [19].…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical study of endocrine cells in ductal adenocarcinoma of the pancreas

et al. 2002

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To clarify whether scattered endocrine cells in pancreatic ductal adenocarcinoma are neoplastic or not, we immunohistochemically studied 29 cases of invasive pancreatic ductal adenocarcinomas, 17 with metastases, for chromogranin A, insulin, glucagon, pancreatic polypeptide, serotonin, gastrin, laminin, and Ki-67. Endocrine cells were found in primary sites in 24 cases (82.3%), where endocrine cells showed at least a visibly close location to adjacent islet cells. Although endocrine cells in neoplastic glands were within the neoplastic basement membrane, endocrine cells were not seen in invasive sites beyond the pancreas where islets were not present. Endocrine cells in neoplastic glands were reactive for two or three of the islet hormones in all cases, and different types of hormonal reactivity was recognized in the same neoplastic gland or the same cluster of neoplastic glands in 22 (91.7%) cases, thus suggesting a close relation with islets. Ki-67 did not stain any endocrine cells in ten of the adenocarcinomas studied. In three (10.3%) cases, endocrine cells were found in the intraductal extensions. They may have pre-existed in non-neoplastic ducts. In 17 cases with metastatic sites, all but one had no endocrine cells in the metastases. Serotonin-positive cells were found in one metastatic lymph node in one case. We concluded that most endocrine cells seen in ductal adenocarcinomas of the pancreas are non-neoplastic and are derived from the surrounding islets. Some neoplastic endocrine cells may exist, though their frequency is low.

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Neuroendocrine Differentiation in Pancreatic Duct Carcinoma Special Emphasis on Duct-Endocrine Cell Carcinoma of the Pancreas

Cited by 25 publications

References 14 publications

Carcinoma of the Pancreas with Neuroendocrine Differentiation and Nodular Panniculitis

Carcinoma of the Pancreas with Neuroendocrine Differentiation and Nodular Panniculitis

Immunohistochemical Characterization of Pancreatic Tumors Induced by Dimethylbenzanthracene in Rats

Immunohistochemical study of endocrine cells in ductal adenocarcinoma of the pancreas

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