Pancreatic Polypeptide Cell Proliferation in the Pancreas and Duodenum Coexisting in a Patient With Pancreatic
Geoffrey A Talmon1, J David Wren, Christophe L Nguyen
1From the *Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE; †Department of Pathology, Spartanburg Medical Center; ‡Gibbs Cancer Center, Spartanburg Regional Hospital System; and §Department of Surgery, Gibbs Cancer Center, Spartanburg, SC; and ∥UNMC Eppley Cancer Center, University of Nebraska Medical Center, Omaha, NE.
Abstract:
A partial pancreaticogastrodudenectomy was performed on a 66-year old man with type 2 diabetes mellitus because of an invasive, moderately differentiated adenocarcinoma in the head of the pancreas. In the adjacent grossly normal tissue of the uncinate process, there was a massive proliferation of pancreatic polypeptide (PP) cells confined to this region and showed invasive pattern. Strikingly, in the heaped area of his duodenum, there was a strikingly large number of PP, glucagon, a few insulin cells in a mini-islet-like patterns composed of glucagon and insulin cells. Among the etiological factors, the possible long-lasting effects of the GLP-1 analog, with which the patient was treated, are discussed. This is the first report in the literature of both the coexistence of a pancreatic adenocarcinoma and invasive PPoma and the occurrence of PP and insulin cells in human duodenal mucosa.
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