Islet functional beta cell tumor

Introduction to islet functional beta cell tumor Islet beta cell tumor is a secretory adenoma or carcinoma formed by islet cells. More than 20 to 50 years old, more than 90% of the single hair is benign, and occasionally part of the type I multiple endocrine neoplasia. Islet cell tumors are relatively rare, mostly benign and a few malignant. The main clinical manifestations of insulinoma are hypoglycemia syndrome and elevated serum insulin. The main clinical manifestations of insulinoma are hypoglycemia syndrome and elevated serum insulin. Gastric secretion of secretory tumors can cause Zollinger-Ellison syndrome, clinical manifestations of difficult to cure digestive ulcers. Non-functional islet cell tumors generally have no clinical symptoms, and may cause symptoms such as abdominal pain, weight loss, and jaundice due to tumor growth, peripancreatic invasion, and distant metastasis. basic knowledge The proportion of illness: 0.005% Susceptible people: 20 to 50 years old. Mode of infection: non-infectious Complications: abdominal pain jaundice

Islet functional beta cell tumor etiology

Functional cell tumors (85%):

Insulinoma is the most common, accounting for 60-90%. The tumor-prone site is the pancreatic body, and the tail is usually small, mostly less than 2.0cm.

Non-functional cell tumors (15%):

Followed by gastrinoma (gastrinoma), accounting for 20%, often multiple, can occur outside the pancreas, more common in the duodenum and stomach wall, other rare islet cell tumor is glucagonoma (glucagonoma), blood vessels Active intestinal peptide tumors (vipoma) and somatostatinoma (somatostatinoma), etc., non-functional islet cell tumors are usually large, even more than 10 cm.

Islet functional beta cell tumor prevention

There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.

Islet functional beta cell tumor complications Complications, abdominal pain, jaundice

Later, due to tumor growth and peripancreatic infiltration and distant metastasis, symptoms such as abdominal pain, weight loss, and jaundice may be caused.

Islet functional beta cell tumor symptoms Common symptoms pale pale fatigue dizziness hypoglycemia

The onset is slow, and a small number of patients have been diagnosed for a long time. If long-term misdiagnosis can cause permanent brain damage, the clinical manifestations are:

First, Whipple triad:

1 symptoms of hypoglycemia after hunger or exercise.

2 Blood sugar <2.8mmol/L (50mg/dl) at the time of onset.

3 Immediately after the injection of glucose.

Second, the onset of hypoglycemia often occurs with the prolongation of the disease course, the prolonged attack time, the degree of hypoglycemia is aggravated, and even hypoglycemia can be induced after the meal, accompanied by the body gradually obese, memory, and decreased reactivity.

Examination of islet functional beta cell tumor

1. Blood sugar <2.8mmol/L (50mg/dl) at the time of onset.

2, serum insulin and C peptide: plasma insulin and C-peptide increased in hypoglycemia, insulin index (insulin / blood glucose) > 0.3, such as > 1.0 can be sure diagnosis, fasting plasma insulin > 200uU / ml can be surely diagnosed.

3, oral glucose tolerance test: typical is a low-flat curve, part of the glucose tolerance decreased, a small number of early hypoglycemia or normal glucose tolerance curve.

4, starvation test: positive help diagnosis, fasting blood glucose >2.8mmol / L can be tested, more than 90% fasting 24-36h can stimulate hypoglycemia, a few need to fast 48-72h, and 2h before the end of fasting Plus exercise, can stimulate hypoglycemia, after 72h fasting did not induce hypoglycemia, can be excluded from the disease.

5, conventional X-ray: Gastrinoma patients with digestive tract locks can show multiple stomach and duodenum, recurrent ulcers.

6, ultrasound performance: lesions in the edge of the pancreas or pancreas, round or elliptical, low echo in the mass, clear edges, malignant islet cell tumor boundary is irregular, internal echo is not uniform.

7, CT performance:

(1) Sweeping an equal-density mass in the pancreas, which is small, may include burying in the pancreas or locally protruding from the surface of the pancreas.

(2) Because functional islet cell tumors are both benign and malignant, they are multi-vascular and rich in blood for tumors. Therefore, the early enhancement (hepatic arterial phase) of the enhanced scan is markedly enhanced with high-density nodules, higher than the surrounding normal pancreas.

(3) Non-functional tumors are usually large, uniform or uneven in density, mostly in the body of the pancreas and the tail. About 20% of the tumors have calcification in the tumor. After enhancement, they may be strengthened. The density is slightly higher than that of the normal pancreas. .

(4) If combined with local lymphadenopathy or involvement or metastasis of adjacent organs, it is a sign of malignant tumor.

8. Angiography: The tumor density in the parenchymal phase is continuously increased, and the tumor staining with clear edges is characteristic.

Diagnosis and identification of islet functional beta cell tumor

1. Functional islet cell tumors Because of its typical CT findings and characteristic clinical syndromes and laboratory findings, it is not difficult to make a correct diagnosis.

2, non-functional islet cell tumors need to be differentiated from pancreatic cancer.

1 Non-functional islet cell tumors are large, often exceeding 10 cm in diameter, while pancreatic cancer masses are relatively small.

2 The former is a multi-vessel disease, and the density of the tumor after the enhanced scan is generally higher than that of the normal pancreas, while the latter is the opposite.

3 The former has a higher calcification rate (20%-25%); the latter has less (2%).

4 The former generally does not appear around the posterior pancreatic artery, such as the celiac trunk and superior mesenteric artery, while the latter is common.

5 The former intrahepatic metastasis also manifested as multi-vascular enhanced nodules, while the latter was reversed.

3, should pay attention to the identification of epilepsy, cerebrovascular accident, rickets, mental disorders and other causes of hypoglycemia.

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