RT Journal Article
SR Electronic
T1 Functional and Morphologic Characterization of Human Insulinomas
JF Diabetes
JO Diabetes
FD American Diabetes Association
SP 921
OP 931
DO 10.2337/diab.32.10.921
VO 32
IS 10
A1 Berger, Michael
A1 Bordi, Cesare
A1 Cüppers, Hans-J
A1 Berchtold, Peter
A1 Gries, F Arnold
A1 Münterfering, Horst
A1 Sailer, Rudolf
A1 Zimmermann, Horst
A1 Orci, Lelio
YR 1983
UL http://diabetes.diabetesjournals.org/content/32/10/921.abstract
AB Circulating levels of insulin, proinsulin-like component, glucagon, growth hormone, and pancreatic polypeptide were measured in 12 patients with functioning insulinomas, and the suppressibility of serum insulin by somatostatin and diazoxide was assessed before surgical removal of the tumors. The hormone content of the tumors was evaluated by radioimmunoassay and by immunofluorescence and the structure of the tumor cells by electron microscopy. Based on these findings, we propose a new classification of insulinomas in two groups: group A is characterized morphologically by abundant well-granulated typical B-cells, trabecular arrangement of tumor cells, and uniform insulin immumofluorescence; functionally, these tumors are associated with a moderate elevation of proinsulin-like component and with an almost complete suppressibility of serum insulin by somatostatin and diazoxide. In contrast, tumors of group B are characterized by scarce well-granulated typical B-cells, a medullary-type histologie structure, and irregular insulin immunofluorescence; functionally these tumors show elevated circulating levels of proinsulin-like component and a marked resistance of insulin secretion to somatostatin and diazoxide inhibition. This way of separating human insulinomas in groups A and B represents a simplification of existing classifications and emphasizes the quantitative ultrastructure in relationship to suppressibility of insulin secretion. The proposed classification of human insulinomas in groups A and B, however, does not allow the assessment of the clinical or histopathologic malignancy of the tumors.