[Gastro-entero-pancreatic endocrine system neoplasms (pancreatic endocrine system neoplasms)].
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After a short latency (15 weeks), a 100% incidence of pancreatic neoplasms was induced in Syrian golden hamsters, following the administration of 2,2'-dihydroxy-di-n-propylnitrosamine (DHPN). Data extracted from reports of human pancreatic neoplasms were compared with findings relative to the induced neoplasms. The latter resembled human pancreatic tumors, in both biological and morphological aspects.
The vascular architecture of the pancreas has been described, but few reports indicate preoperative accuracy. During the last 3 years, selective superior mesenteric and celiac angiography was performed in 471 patients. In 35 of these patients, additional selective angiography of the superior pancreaticoduodenal and inferior pancreaticoduodenal arteries was performed to reveal the detailed vascular pattern of the pancreas and its surrounding structures. Exploratory surgery was performed in all patients except the four control subjects. The angiographic findings reflected a poorly vascularized infiltrating lesion with invasion of the blood vessels and serpiginous encasements. Peripancreatic extension of the tumor indicated nonresectability. In early pancreatitis, the pancreas showed increased vascularity and occasional stretched vessels. In more advanced pancreatitis, the arteries were prominent and irregular with increased parenchymal accumulation of contrast medium in the capillary phase. In pseudocysts of the pancreas, the only finding was stretching of the vessels around the lesion. A well circumscribed lesion with increased contrast medium in the capillary and venous phases diagnostic of pancreatic adenoma. Pancreatic angiography is an important diagnostic tool in evaluating and staging pancreatic neoplasms.
Among all cancers of the pancreas, the liver and the bile ducts with icterus terminal lung embolism ist seldomer then among the same cancers without icterus. The risk of terminal lung embolism is among all tumours of the abdominal region higher than among all tumours of the thorax region, because the compression of the vena cava inferior increases the risk of thrombosis with lung embolism. The prevalence of adenocarcinoma among all cases with lung embolism is caused by the fact, that cancers of the abdomen are more frequent adenocarcinomas then all other tumours.
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Explore the source record for details and available documents.
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The tumor-forming endocrine cells of the pancreas belong to the APUD system. These cells are of neuroectodermal origin. The tumor can be diagnosed in most cases by a distinct clinical picture, and the diagnosis can be veryfied by direct hormone determination or/and by the biochemical disorders caused by the hormones. For localisation angiography, szintigrams, endoscopic pancreatography, and sonograms were used up to now without convincing results in many cases; computerized tomography promises to be the decisive examination in the future. Three hormones can, up to now, not yet be correlated with a distinct clinical picture specific for a pancreatic tumor. On the other hand, four tumors are responsible for a very typical clinical entity, the insulinoma, the glucagonoma, the gastrinoma, and the vipoma, as illustrated by our own cases. The surgical therapy consists mainly in enucleation of an adenoma or in partial pancreatic resection. Total pancreatectomy is indicated only in few cases. The Zollinger-Ellison syndrome is treated best by total gastrectomy. Malignant tumors are sensible to streptozotozin.
The results of 100 consecutive pancreatic arteriograms performed in concert with a combination of other diagnostic procedures (gray scale ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography) were evaluated to determine the value of angiography in diagnosis and management of patients with known or suspected pancreatic disease. Angiography was found to be valuable for diagnosis in 68% (68/100) of cases and was considered helpful for management in 81% (57/70) of patients with pancreatic neoplasm, pancreatitis, or a nonpancreatic abnormality.
Neoplasms of pancreatic islet cells that produce widely divergent clinical syndromes cannot be distinguished from one another by conventional microscopy. Differentiation among these tumors by electron microscopy is possible in some cases only. Coordinated clinical evaluation, histochemical and ultrastructural studies, and assay of serum and neoplastic tissue for various polypeptide hormones afford the best characterization of these neoplasms.
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Oral administration of N-nitrosobis(2-oxopropyl)amine (BOP) in drinking water to Syrian golden hamsters for 90 days resulted in a high incidence of intra- and extrahepatic bile duct neoplasms. Only a few pancreatic neoplasms and no lung and kidney tumors developed, in contrast to results obtained after subcutaneous BOP administration.