Harano Y, Kohama M, Araki N, Sakamoto A, Hoshi M
Endocrinol Jpn. 1975 Apr;22(2):175-80. doi: 10.1507/endocrj1954.22.175.
We have presented here a case of atypical insulinoma. Despite the recurrent episodes of hypoglycemic symptoms, the plasma level of insulin has never been excessive at fasting or by regular provocative tests. Detailed examination had demonstrated qualitative abnormality of insulin secretion. Hyposuppressibility of insulin secretion by hypoglycemia, borderline diabetic curve of glucose tolerance test, blunted response ot insulin to glucagon and leucine were the principle characteristics of these abnormalities. After removal of adenoma, insulin response to glucose, glucagon and leucine was improved. Only secretion provoked a high level of insulin and this abnormal elevation was no longer seen after the removal of adenoma. A removed elevation was no longer seen after the removal of adenoma. A removed insulinoma contained 25 U of immunoreactive insulin per gram tissue, but was negative for aldehyde-fuchsin staining. On electromicroscopy only atypical beta-cell granules were seen.
我们在此报告一例非典型胰岛素瘤病例。尽管有反复出现的低血糖症状发作，但空腹时或通过常规激发试验，胰岛素的血浆水平从未过高。详细检查显示胰岛素分泌存在定性异常。低血糖对胰岛素分泌的抑制不足、葡萄糖耐量试验呈临界糖尿病曲线、胰岛素对胰高血糖素和亮氨酸的反应减弱是这些异常的主要特征。切除腺瘤后，胰岛素对葡萄糖、胰高血糖素和亮氨酸的反应有所改善。仅刺激分泌会引发高水平的胰岛素，切除腺瘤后这种异常升高不再出现。切除腺瘤后不再出现异常升高。切除的胰岛素瘤每克组织含有25单位免疫反应性胰岛素，但醛复红染色呈阴性。电镜检查仅可见非典型的β细胞颗粒。
