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  • Anlauf, MartinUniv Kiel, Dept Pathol, D-24105 Kiel, Germany,Department of Pathology, University of Kiel, Kiel, Germany (author)

Primary lymph node Gastrinoma or occult duodenal microgastrinoma with lymph node Metastases in a MEN1 patient - The need for a systematic search for the primary tumor

  • Article/chapterEnglish2008

Publisher, publication year, extent ...

  • 2008
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-47964
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-47964URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-101883URI
  • https://doi.org/10.1097/PAS.0b013e3181655811DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Gastrinoma tissue has been found frequently in lymph nodes located near the duodenum without a known primary tumor. Therefore, it has been suggested that a primary lymph node gastrinoma exists. We report on a 38-year-old woman suffering from multiple endocrine neoplasia type 1 (MEN 1) confirmed by menin gene mutation analysis. MEN1 disease started with primary hyperparathyroidism followed by Cushing disease, the detection of tumors of the pituitary, adrenal cortex, and the pancreas and also an elevated serum gastrin level. An octreotide scan revealed 4 tumors in the upper abdomen. A selective arterial calcium stimulation test located the source of the hypergastrinemia to the area of the gastroduodenal and the superior mesenteric arteries. Total pancreatoduodenectomy was performed and conventional histopathologic examination revealed a well-differentiated cystic neuroendocrine tumor of the pancreas expressing glucagon and accompanied by several microadenomas. In addition, 3 suprapancreatic lymph nodes with gastrin-positive endocrine tissue were found. None of the pancreatic microadenomas expressed gastrin and no duodenal endocrine tumor was found despite careful macroscopic examination. Only after complete embedding of the duodenal and pancreatic tissue in 65 paraffin blocks, 2 microgastrinomas (0.45 and 0.8 mm in diameter) were identified in the duodenum. It is concluded that duodenal gastrinomas that give rise to lymph node metastases may be so tiny that they are easily overlooked in a routine examination and that systematic tissue monitoring is required to identify them.

Subject headings and genre

  • duodenal gastrinoma
  • lymph node metastases
  • multiple endocrine neoplasia type 1
  • Zollinger-Ellison syndrome
  • NATURAL SCIENCES
  • NATURVETENSKAP

Added entries (persons, corporate bodies, meetings, titles ...)

  • Enosawa, TetsujiUniv Kiel, Dept Pathol, D-24105 Kiel, Germany,Department of Pathology, University of Kiel, Germany / First Department of Pathology, Showa University, Japan (author)
  • Henopp, TobiasUniv Kiel, Dept Pathol, D-24105 Kiel, Germany,Department of Pathology, University of Kiel, Germany (author)
  • Schmitt, AnjaUniv Zurich, Dept Pathol, CH-8006 Zurich, Switzerland,Department of Pathology, University of Zurich, Switzerland (author)
  • Gimm, OliverLinköpings universitet,Östergötlands Läns Landsting,Kirurgi,Hälsouniversitetet,Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany(Swepub:liu)oligi51 (author)
  • Brauckhoff, MichaelUniv Halle, Dept Gen Visceral & Vasc Surg, Halle, Germany,Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany (author)
  • Dralle, HenningUniv Halle, Dept Gen Visceral & Vasc Surg, Halle, Germany,Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany (author)
  • Musil, AnetteUniv Halle, Dept Pathol, Halle, Germany,Department of Pathology, University of Halle, Halle, Germany (author)
  • Hauptmann, SteffenUniv Halle, Dept Pathol, Halle, Germany,Department of Pathology, University of Halle, Halle, Germany (author)
  • Perren, AurelTech Univ Munich, Klinikum Rechts Isar, Dept Pathol, D-8000 Munich, Germany,Department of Pathology, Technische Universitat Munchen, Klinikum Rechts der Isar, Germany (author)
  • Kloeppel, GuenterUniv Kiel, Dept Pathol, D-24105 Kiel, Germany,Department of Pathology, University of Kiel, Kiel, Germany (author)
  • Univ Kiel, Dept Pathol, D-24105 Kiel, GermanyDepartment of Pathology, University of Kiel, Kiel, Germany (creator_code:org_t)

Related titles

  • In:American Journal of Surgical Pathology32:7, s. 1101-11050147-51851532-0979

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