ホルモン産生性膵島腫の5症例

Five Cases of Hormone-producing Adenoma of the Pancreatic Islet

　膵島は数種の異なるホルモンを産生する細胞から成り，そこに生ずる腫瘍にはホルモン産生能を保持して臨床的に特有なホルモン過剰症を顕わす症例も稀でない．先ず1927年Wilder et al．がインシュリン産生β細胞腫を報告，手術的摘除により完治せしめ得る事から症例の報告が次第に増して来た．続いて1955年Zollinger，Ellisonは多発性胃潰瘍と胃液亢進を主症状とするいわゆるZollinger-Ellison症候群を呈する非β細胞腫を報告，後にガストリン産生亢進が認められた．他にグルカゴン産生α細胞腫の症例や，又膵島細胞とは直接の関係は明らかでないが，セロトニン産生のカルチノイド症例等も確認されている．本学中央検査部病理検査室で経験された膵島腫瘍の手術摘出症例8例から数例を選び報告する．

　Five cases of hormone-producing adenoma of the pancreatic islet, which are obtained from all 8 cases examined in our laboratory for past 12 years (1962～1974), are presented here.

　Case 1, 47 ys. female, is β-cell adenoma with typical Whipple's Trias and successfully removed by pancreatic resection at caudal 2/3 part, but Case 2, 64 ys. female, is not regressed by same treatment due to multiple adenomatosis. Case 3, 66 ys. male, is clinically overlooked hypoglycemia by his psychotic unusuality by v. Recklinghausen's disease and on the autopsy table β-cell adenoma revealed ectopically on the duodenal wall. Case 4, 30 ys. male, is multiple adenomatosis appearing typical Whipple's Trias clinically, and above adenomas are 2 β-cell adenomas, and smaller α-cell adenoma and non-β-cell adenoma. Case 5, 46 ys. female, is pancreatic carcinoid tumor associated by lymph node metastases and appears clinically multiple ulcers on the stomach. Histologically each tumors are not always unicellularity and predominant cell component may determine the clinical manifestation.