복합내분비샘신생물 제 1형 환자에서 다양한 호르몬 발현을 보이는 다발성 이자샘세포종양 - 1예 보고 -
Multiple Pancreatic Islet Cell Tumors with Diverse Hormonal Expression in a Multiple Endocrine Neoplasia Type I Patient: A Case Report
김장한, 이건욱, 김우호, 김용일,
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김장한 ( Kim Jang-Han )
서울대학교 의과대학 병리학교실
이건욱 ( Lee Kuhn-Uk )
서울대학교 의과대학 외과학교실
김우호 ( Kim Woo-Ho )
서울대학교 의과대학 병리학교실
김용일 ( Kim Yong-Il )
서울대학교 의과대학 병리학교실
KMID : 0357920020360030184
Abstract
Multiple endocrine neoplasia type I is characterized by multiple tumors, particularly in the parathyroid glands, the pituitary gland and the pancreatic islet. We observed multiple pancreatic islet cell tumors with diverse hormonal expression in a MEN-I patient. The patient suffered from protracted diarrhea and multiple gastrododuodenal ulcers for 10 years. In abdominal computed tomography, space occupying lesions were detected in the distal pancreas. Distal pancreatectomy was done. Three tumors that measured 2.0 X 1.0 cm (A), 1.0 X 1.0 cm (B), and 1.0 X 0.5 cm (C) were discovered. Microscopic examination revealed another tumor, 1.0 X 0.5 cm (D). Microadenomas, less than 0.5 cm, were also found throughout the pancreas. Immunohistochemical stainings for insulin, pancreatic polypeptide, gastrin, glucagon, somatostain, and chromogranin were performed. Tumor A was trabecular and acinar in form and showed weak cytoplasmic reactivity to insulin. Tumor B was a gyriform and a few cells showed cytoplasmic reactivity to pancreatic polypeptide. Tumor C was trabecular in form and showed cytoplasmic reactivity to chromogranin. Direct invasion and distant metastasis were not found.
키워드
Multiple Endocrine Neoplasia Type 1;Pancredtic Neoplasms;Adenoma;Islet Cell
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