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Functional and morphologic characterization of human insulinomas.

M Berger, C Bordi, H J Cüppers

    Diabetes
    |October 1, 1983
    PubMed
    Summary
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    This study proposes a new classification for insulinomas based on tumor cell characteristics and insulin secretion suppressibility. The two groups, A and B, differ in cell morphology, hormone levels, and response to somatostatin and diazoxide.

    Area of Science:

    • Endocrinology
    • Oncology
    • Pathology

    Background:

    • Functioning insulinomas are tumors producing excess insulin.
    • Understanding insulinoma subtypes is crucial for diagnosis and treatment.
    • Existing classifications may not fully capture functional and structural heterogeneity.

    Purpose of the Study:

    • To propose a new classification system for functioning insulinomas.
    • To correlate tumor morphology and hormone content with insulin secretion suppressibility.
    • To differentiate insulinoma subtypes based on biochemical and ultrastructural findings.

    Main Methods:

    • Measurement of circulating hormones (insulin, proinsulin-like component, glucagon, growth hormone, pancreatic polypeptide).
    • Assessment of serum insulin suppressibility by somatostatin and diazoxide.

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  • Evaluation of tumor hormone content (radioimmunoassay, immunofluorescence) and cell structure (electron microscopy).

    • Main Results:

    • A new two-group classification (A and B) of insulinomas is proposed.
    • Group A: Abundant B-cells, trabecular structure, uniform immunofluorescence, moderate proinsulin elevation, high suppressibility.
    • Group B: Scarce B-cells, medullary structure, irregular immunofluorescence, elevated proinsulin, resistant to suppression.

    Conclusions:

    • The proposed classification simplifies existing systems by linking ultrastructure to insulin secretion suppressibility.
    • This classification aids in understanding the functional heterogeneity of insulinomas.
    • The classification does not predict tumor malignancy.