We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing eccentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosely aggregated and solid sheets or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. This case was confirmed by tissue examination including histochemical, immunohistochemical and electron microscopical studies. Ultrastructurally, the tumor cells contained a few membrane-bound electron dense granules.
Adenoma, Islet Cell ; Chromatin ; Pancreas ; Urinary Tract*

Zollinger-Ellison syndrome (ZES) involves hypergastinemia produced by a gastrin-secreting tumor. Not only can it cause an ulcer but may also behave as a malignant lesion, metastasizing to the liver or other organs. The development of potent antisecretory agents for controlling acid secretion as well as techniques for localizing these islet cell tumors, has led to greatly improved survival rates. We describe a case of Zollinger-Ellison syndrome, emphasising the radiologic findings, and including a review of the literature.
Adenoma, Islet Cell ; Liver ; Survival Rate ; Ulcer ; Zollinger-Ellison Syndrome*

It is difficult to distinguish an islet tumor originating from heterotopic pancreas tissue from the other submucosal tumors. Although the malignant transformation of a heterotopic pancreas, including islet cell tumor, is extremely rare, it remains an important consideration in the differential diagnosis of duodenal submucosal masses. We have demonstrated the radiologic appearance and the clinical-pathologic findings of a highlighted, rare case of islet cell tumor arising from a heterotopic pancreas in the duodenal wall.
Adenoma, Islet Cell* ; Diagnosis, Differential ; Duodenum* ; Islets of Langerhans* ; Pancreas*

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.
Adenoma, Islet Cell ; Insulinoma* ; Islets of Langerhans ; Laparoscopy ; Pancreas

We present the cytologic features of a case of solid and papillary neoplasm of the pancreas. Cytologically, the tumor was composed of a monotonous population of polygonal cells containing ecentrically located round nuclei with one or two distinct small nucleoli and a finely stippled chromatin pattern. The tumor cells were similar to those of the islet cell tumor and showed isolated loosety aggregated and solid sheedts or large cell clumps. The large cell clumps revealed a branching papillary structure containing fibrovascular central core, which is characteristic histologic feature of solid and papillary neoplasm of the pancreas. The case was confirmed by tissue examination including histochemical immunohistochemical and electron microscopical studies. Utrastructurally, the tumor cells contanined a few membrane-bound electron dense granules.
Adenoma, Islet Cell ; Biopsy, Fine-Needle* ; Chromatin ; Pancreas*

Among cystic tumors arising in the pancreas, microcystic adenoma is relatively uncommon; it is usually benign, and is comprised of cysts that vary in size from microscopic to 2cm in diameter. It has recently been reported to be associated with other pancreatic tumors with malignant potential; in particular, microcystic adenoma with coexistent islet cell tumor has been reported in von Hippel-Lindau disease. We report a case of microcystic adenoma of the pancreas associated with coexistent surgically-proven islet cell tumor. On spiral CT, the islet cell tumor was seen as a highly enhanced inhomogeneous solid mass in the pancreatic head, and microcystic adenoma as numerous small cysts throughout the pancreas.
Adenoma* ; Adenoma, Islet Cell* ; Head ; Islets of Langerhans* ; Pancreas* ; Tomography, Spiral Computed ; von Hippel-Lindau Disease

Hyperinsullinism and the resultant hypoglycemia are hallmarks of functioning beta islet cell tumors of the pancreas. The management of one case of insulinoma during surgery for the removal of the tumor is described and the available literature on the subject reviewed. The outline of the anesthetic management for the insulinoma is as follows: 1) Anesthetists should understand the signs and the symptoms of hypoglycemia and hyperglycemia. 2) Preoprative management: a) infusion of glucose for avoiding hypoglycemia due to NPO after midnight. b) glucocorticosteroid administration with premedications. 3) Operative management: a) continuous determination of blood glucose level may be helpful. b) Maintenance of the glucose level about 50mg% above symptomatic CNS level have the advantage that exicision of the infulinoma can be immediately judged. c) The use of an agent that decreases CMRO2 and does not affect the insulin-glucose ratio is rational choice when concern about hypoglycemia exists. Thiopental-enflurane anesthesia with controlled ventilation maintaining normocarbia is recommended. d) beta-adrenergic blocker. These drugs must be avoided in the hypoglycemic state.
Adenoma, Islet Cell ; Anesthesia ; Blood Glucose ; Glucose ; Hyperglycemia ; Hypoglycemia ; Insulinoma ; Pancreas ; Premedication ; Ventilation

PURPOSE: To evaluate the usefulness of the arterial dominant phase images of spiral CT in the detection and localization of pancreatic islet cell tumor. MATERIALS AND METHODS: Six patients with pathologically proven isletcell tumors of the pancreas were studied with two-phase spiral CT. Images of the arterial dominant phase and delayed phase were obtained at 30 and 180 seconds after the initiation of injection of 100 ml of contrast materialat a rate of 3ml/sec. The parameters of scanning were 3-mm thickness, table speed of 4mm/sec, and reconstruction at 2-mm intervals. Images were prospectively analyzed and the operative findings were used as the reference standard for tumor detection and localization. RESULTS: On arterial dominant phase images, lesions were definitely depicted in five patients(83%) and were suspicious in one (17%). In the delayed phase, only two tumors(33%) were demonstrated. CONCLUSION: The arterial dominant phase of spiral CT is useful in the preoperative detection and localization of islet cell tumor of the pancreas.
Adenoma, Islet Cell* ; Humans ; Islets of Langerhans* ; Pancreas* ; Prospective Studies ; Tomography, Spiral Computed*

No abstract available.
Adenoma, Islet Cell* ; Adult* ; Diabetes Mellitus, Type 2* ; Humans ; Islets of Langerhans* ; Nesidioblastosis*

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.
Adenoma, Islet Cell ; Adolescent ; Child ; Diagnosis, Differential ; Humans ; Lymphatic Diseases ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors