From the *Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, Marburg; and †Department of Pathology, Consultation Center for Pancreatic and Endocrine Tumors, Technical University of Munich, Munich, Germany.
Pancreas. 2014 May;43(4):648-50. doi: 10.1097/MPA.0000000000000070.
A 74-year-old man with recurrent duodenal ulcers underwent somatostatin receptor scintigraphy (SRS) in suspicion of gastrinoma. A 2-cm area of focal uptake was visualized within the pancreatic head. Serum chromogranin A levels were elevated, but serum gastrin levels and the secretin test were normal. Computed tomography and endoscopic ultrasonography were not conclusive. After partial duodenopancreatectomy, pathological examination failed to reveal any neuroendocrine tumor. Instead, the dorsal portion of the pancreatic head was found to be densely populated by pancreatic polypeptide cell-rich islets. This area correlated with the site of tracer uptake seen on SRS. Thus, pancreatic polypeptide cell-rich islets in elderly patients should be kept in mind when interpreting SRS results to avoid unnecessary major pancreatic resections.
一位 74 岁的老年男性因复发性十二指肠溃疡接受生长抑素受体闪烁扫描（SRS）检查，怀疑为胃泌素瘤。在胰头部可见到 2 厘米大小的局灶性摄取区域。血清嗜铬粒蛋白 A 水平升高，但血清胃泌素水平和促胰液素试验正常。计算机断层扫描和内镜超声检查没有明确结论。行胰十二指肠部分切除术，病理检查未发现任何神经内分泌肿瘤。相反，胰头部背侧被富含胰多肽细胞的胰岛密集占据。该区域与 SRS 上观察到的示踪剂摄取部位相对应。因此，在解释 SRS 结果时，应注意老年患者的富含胰多肽细胞的胰岛，以避免不必要的胰大部切除术。
