[Malignant nesidioma with 2 types of secretory granules in tumor cells]

A case has been described of a male aged 38 with a malignant nesidioma. The clinical examination disclosed marked hepatomegaly, variable hypertension associated with cool sweating, agitation and transient hyperglycaemia. The primary tumour as well as the metastases in the liver weighing over 13 kg were histologically of trabecular structure and stained positively with the methods of Bodian and grimelius. The impregnation for D-cells according to Rohoznická and Vortel was positive in isolated cells only. Ultrastructurally, the tumor cells could be divided in two types. The more numerous Type I cells contained rather small secretory granules morphologically resembling A granules of islet cells, and staining positively with impregnation methods for A-cells on the ultrastructural level. Type II cells contained, in addition to the formerly described ones, another type of granules appearing as large, slightly osmiophilic ones characteristic of the D-cells of Langerhan's islets and positive with the impregnation methods for D-cells. The type II tumour cells must be therefore regarded as a mixed cell type containing two types of secretory granules.