Albers N, Löhr M, Bogner U, Loy V, Klöppel G
Institute of Pathology, University of Hamburg, Berlin, West Germany.
Am J Clin Pathol. 1989 Mar;91(3):336-40. doi: 10.1093/ajcp/91.3.336.
The rare finding of pancreatic nesidioblastosis in an adult is described. A 43-year-old woman presented with a two-year history of hypoglycemic hyperinsulinism. Extensive diagnostic procedures revealed no insulinoma. Subtotal (75%) pancreatectomy relieved her symptoms; she has normal insulin levels 2.5 years after surgery. The pancreatic specimen revealed only discrete islet cell abnormalities, namely B-cells budding off ductular epithelium, islets in apposition to ducts, slight islet cell hypertrophy, and islet enlargement. Immunohistochemistry showed normal total endocrine cell content as well as normal proportions of islet cell subpopulations. Review of 20 cases in the literature and the authors' experience led to subtotal (75-90%) pancreatectomy as the treatment of choice. The authors conclude that the pediatric disease of nesidioblastosis may rarely occur in adults and that the paucity of histologic findings makes the exclusion of an insulinoma mandatory.
本文描述了一例罕见的成人性胰岛母细胞增生症病例。一名43岁女性有两年低血糖性高胰岛素血症病史。广泛的诊断检查未发现胰岛素瘤。行胰腺次全切除术（切除75%）后症状缓解；术后2.5年胰岛素水平正常。胰腺标本仅显示散在的胰岛细胞异常，即B细胞从导管上皮出芽、胰岛与导管相邻、轻度胰岛细胞肥大以及胰岛增大。免疫组化显示内分泌细胞总量正常以及胰岛细胞亚群比例正常。回顾文献中的20例病例及作者的经验，得出胰腺次全切除术（切除75 - 90%）为首选治疗方法。作者得出结论，胰岛母细胞增生症这种儿科疾病在成人中可能罕见发生，且组织学表现缺乏使得排除胰岛素瘤成为必要。
