Buetow P C, Miller D L, Parrino T V, Buck J L
Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
Radiographics. 1997 Mar-Apr;17(2):453-72; quiz 472A-472B. doi: 10.1148/radiographics.17.2.9084084.
Islet cell tumors are rare pancreatic or peripancreatic neoplasms that produce and secrete hormones to a variable degree. These tumors are best divided on clinical grounds into those that produce a recognizable, clinically evident endocrine syndrome (ie, functioning) and those that exhibit no clinical evidence of hormone production (ie, clinically silent). Clinically silent tumors produce symptoms due to mass effect because of their large size. They are often partially cystic or necrotic. Functioning islet cell tumors usually manifest earlier in the course of the disease because of the distinctive signs and symptoms of the associated endocrine syndrome. Clinically silent and functioning tumors cannot be histologically distinguished reliably even with the use of immunohistochemical stains. Insulinoma and gastrinoma, the two most common functioning lesions, are typically small homogeneous masses. Other functioning islet cell tumors include glucagonoma, somatostatinoma, vipoma, and adrenocorticotropic hormone-producing tumor. Larger tumors are associated with calcification, cystic degeneration and necrosis, and a more aggressive behavior (local and vascular invasion as well as distant metastases). There are many different techniques for detection and characterization of these lesions that are usually chosen according to the radiologist's experience and preference. Treatment and prognosis of these lesions depend on the hormone produced, their size, and their behavior.
胰岛细胞瘤是罕见的胰腺或胰腺周围肿瘤，可不同程度地产生和分泌激素。根据临床情况，这些肿瘤最好分为产生可识别的、临床上明显的内分泌综合征的肿瘤（即功能性肿瘤）和没有激素产生临床证据的肿瘤（即临床无症状肿瘤）。临床无症状肿瘤由于体积大产生占位效应而出现症状。它们通常部分呈囊性或坏死。功能性胰岛细胞瘤由于相关内分泌综合征的独特体征和症状，通常在疾病过程中出现得较早。即使使用免疫组织化学染色，临床无症状肿瘤和功能性肿瘤在组织学上也无法可靠区分。胰岛素瘤和胃泌素瘤是两种最常见的功能性病变，通常是小的均匀肿块。其他功能性胰岛细胞瘤包括胰高血糖素瘤、生长抑素瘤、血管活性肠肽瘤和产生促肾上腺皮质激素的肿瘤。较大的肿瘤与钙化、囊性变和坏死以及更具侵袭性的行为（局部和血管侵犯以及远处转移）相关。有许多不同的技术用于检测和表征这些病变，通常根据放射科医生的经验和偏好来选择。这些病变的治疗和预后取决于所产生的激素、肿瘤大小及其行为。
