Rossi C, Grassi A, Torchio B, Ravarino N, Nasi G, Gallone G, Fonzo D
Divisione di Endocrinologia e Malattie del Ricambio, Ospedale Mauriziano Umberto I, Torino .
Minerva Endocrinol. 1996 Jun;21(2):73-8.
The author describe a rare case of pancreatic beta-cell hyperplasia. The patient was referred to us because of serious hypoglycemic crises. During hospitalization, endogenous hyperinsulinism was confirmed by hematochemical and instrumental tests. AngioCT of the pancreas evidenced a small lesion of the corpus, suspected of insulinoma. The patient underwent a corpus caudalis pancreatectomy: a small nodule with histologic neuroendocrine traits was ablated. A few days after the operation, new symptomatic hypoglycemia appeared. The hormonal tests confirmed a recurrence of endogenous hyperinsulinism. The patient underwent a new operation for pancreaticoduodenectomy: histological examination confirmed a pancreatic beta-cells hyperplasia. This condition has to be taken into account in the differential diagnosis of post prandial hypoglycemia. Besides, the observation of an insulinoma doesn't exclude the presence of a diffused disorder of islet cells as in the case above described.
作者描述了一例罕见的胰腺β细胞增生病例。该患者因严重低血糖危象转诊至我们这里。住院期间，通过血液化学和仪器检查确诊为内源性高胰岛素血症。胰腺血管CT显示胰体有一个小病变，怀疑是胰岛素瘤。患者接受了胰体尾切除术：切除了一个具有组织学神经内分泌特征的小结节。术后几天，出现了新的症状性低血糖。激素检查证实内源性高胰岛素血症复发。患者接受了新的胰十二指肠切除术：组织学检查证实为胰腺β细胞增生。在餐后低血糖的鉴别诊断中必须考虑到这种情况。此外，如上述病例所示，发现胰岛素瘤并不排除存在胰岛细胞弥漫性病变。
