Resnick J M, Manivel J C
Department of Laboratory Medicine and Pathology, University of Minnesota Hospital and Clinics, Minneapolis 55455.
Arch Pathol Lab Med. 1994 Feb;118(2):155-9.
Six extragonadal teratomas that contained pancreatic tissue were retrieved from archival material at the University of Minnesota Hospital, Minneapolis. The neuroendocrine cells were studied immunohistochemically for insulin, glucagon, somatostatin, pancreatic polypeptide, vasoactive intestinal polypeptide, gastrin, chromogranin, and synaptophysin. Pancreatic tissue from autopsies of 10 stillbirths (20 to 40 weeks' gestational age) was evaluated similarly. The features of the teratomatous pancreatic tissue were compared with those of the fetal pancreata and with data from previous studies of normal pancreatic development and adult pancreata. The pancreatic tissue in all six teratomas contained abundant mature islets that contained beta, alpha, delta, and pancreatic polypeptide cells; however, they also showed widespread nesidioblastosis with the same cell types, resembling third-trimester fetal and neonatal pancreata. Increased proportions of alpha and delta cells were observed in three and five cases (relative to those of adult tissue), respectively, providing further evidence of immaturity. Two cases showed a lack of alpha cells. None of the teratomas contained pancreatic cells that were positive for vasoactive intestinal polypeptide or gastrin. Mechanisms that regulate neuroendocrine cell differentiation in the normal pancreas also seem to operate in the teratomatous pancreas; they may eventuate in features similar to those of the late fetal and neonatal pancreas. Abnormal differentiation in teratomas may result in deficient hormone production.
从明尼阿波利斯明尼苏达大学医院的存档材料中获取了6例含有胰腺组织的性腺外畸胎瘤。对神经内分泌细胞进行免疫组织化学研究，检测胰岛素、胰高血糖素、生长抑素、胰多肽、血管活性肠肽、胃泌素、嗜铬粒蛋白和突触素。对10例死产（妊娠20至40周）尸检的胰腺组织进行了类似评估。将畸胎瘤中胰腺组织的特征与胎儿胰腺的特征以及先前关于正常胰腺发育和成人胰腺研究的数据进行了比较。所有6例畸胎瘤中的胰腺组织均含有丰富的成熟胰岛，其中包含β细胞、α细胞、δ细胞和胰多肽细胞；然而，它们也表现出广泛的胰岛母细胞增生，具有相同的细胞类型，类似于孕晚期胎儿和新生儿的胰腺。分别在3例和5例中观察到α细胞和δ细胞比例增加（相对于成人组织），这进一步证明了其不成熟。2例显示缺乏α细胞。所有畸胎瘤均未含有对血管活性肠肽或胃泌素呈阳性的胰腺细胞。正常胰腺中调节神经内分泌细胞分化的机制似乎也在畸胎瘤胰腺中起作用；它们可能最终导致与晚期胎儿和新生儿胰腺相似的特征。畸胎瘤中的异常分化可能导致激素产生不足。
