Talmon Geoffrey A, Wren J David, Nguyen Christophe L, Pour Parviz M
From the *Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE; †Department of Pathology, Spartanburg Medical Center; ‡Gibbs Cancer Center, Spartanburg Regional Hospital System; and §Department of Surgery, Gibbs Cancer Center, Spartanburg, SC; and ∥UNMC Eppley Cancer Center, University of Nebraska Medical Center, Omaha, NE.
Pancreas. 2017 Jul;46(6):820-824. doi: 10.1097/MPA.0000000000000844.
A partial pancreaticogastrodudenectomy was performed on a 66-year old man with type 2 diabetes mellitus because of an invasive, moderately differentiated adenocarcinoma in the head of the pancreas. In the adjacent grossly normal tissue of the uncinate process, there was a massive proliferation of pancreatic polypeptide (PP) cells confined to this region and showed invasive pattern. Strikingly, in the heaped area of his duodenum, there was a strikingly large number of PP, glucagon, a few insulin cells in a mini-islet-like patterns composed of glucagon and insulin cells. Among the etiological factors, the possible long-lasting effects of the GLP-1 analog, with which the patient was treated, are discussed. This is the first report in the literature of both the coexistence of a pancreatic adenocarcinoma and invasive PPoma and the occurrence of PP and insulin cells in human duodenal mucosa.
一名66岁的2型糖尿病男性患者因胰腺头部浸润性中分化腺癌接受了部分胰胃十二指肠切除术。在钩突相邻大体正常的组织中，存在局限于该区域的大量胰多肽（PP）细胞增殖，并呈浸润性模式。引人注目的是，在其十二指肠堆积区域，有大量呈迷你胰岛样模式的PP、胰高血糖素细胞，还有少数胰岛素细胞，该模式由胰高血糖素细胞和胰岛素细胞组成。在病因方面，讨论了患者所接受的GLP-1类似物可能产生的长期影响。这是文献中首例关于胰腺腺癌与浸润性PP瘤并存以及人十二指肠黏膜中出现PP和胰岛素细胞的报道。
