Immunohistochemical assessment of an asymptomatic glucagonoma in a patient with hypergastrinemia and marked antral angiodysplasia

Appl Immunohistochem Mol Morphol. 2001 Mar;9(1):92-6.

Abstract

A 58-year-old patient had been treated for recurrent gastritis. Numerous gastroscopies indicated hemorrhagic gastritis combined with increasingly severe anemia. The patient was admitted with a hemoglobin of 4.4 g/dL. Gastroscopy showed marked antral angiodysplasia. Serum samples for gastrin were taken and found to be elevated (170-250 U/mL). The search for a gastrin-producing tumor with abdominal ultrasound, computed tomography, octreotide scan, and secretin test was negative, but angiography detected a pancreas tumor with a 2-cm diameter. Partial pancreatectomy and partial gastrectomy were performed. Immunohistochemical examination of the tumor did not show a gastrinoma but did show glucagon-reactive tissue. Further tumors or elevated plasma hormone levels were not detected, and a multiple endocrine neoplasia type I syndrome could be excluded. We thus found antral angiodysplasia with hypergastrinemia leading to detection of a glucagonoma diagnosed by immunohistochemistry. After more than 4 years of follow-up, the patient is without any symptoms or signs of relapse or secondary hormone syndrome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diagnosis, Differential
  • Gastric Antral Vascular Ectasia / etiology*
  • Gastric Antral Vascular Ectasia / pathology
  • Gastrins / blood*
  • Glucagon / metabolism
  • Glucagonoma / complications*
  • Glucagonoma / metabolism*
  • Glucagonoma / pathology
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 1 / diagnosis
  • Pancreatic Neoplasms / complications*
  • Pancreatic Neoplasms / metabolism*
  • Pancreatic Neoplasms / pathology
  • Pyloric Antrum / pathology

Substances

  • Gastrins
  • Glucagon