Partial or near-total pancreatectomy for persistent neonatal hyperinsulinaemic hypoglycaemia: the pathologist's role

Aims: To determine whether the presence of abnormal B‐cell nuclei predicts the existence of a focal or of a diffuse form of persistent neonatal and infantile hyperinsulinaemic hypoglycaemia in a series of 20 infants. Methods and results: Intra‐operative frozen sections were performed on small specim...

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Veröffentlicht in:Histopathology 1998-01, Vol.32 (1), p.15-19
Hauptverfasser: RAHIER, J, SEMPOUX, C, FOURNET, J. C, POGGI, F, BRUNELLE, F, NIHOUL-FEKETE, C, SAUDUBRAY, J. M, JAUBERT, F
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container_end_page 19
container_issue 1
container_start_page 15
container_title Histopathology
container_volume 32
creator RAHIER, J
SEMPOUX, C
FOURNET, J. C
POGGI, F
BRUNELLE, F
NIHOUL-FEKETE, C
SAUDUBRAY, J. M
JAUBERT, F
description Aims: To determine whether the presence of abnormal B‐cell nuclei predicts the existence of a focal or of a diffuse form of persistent neonatal and infantile hyperinsulinaemic hypoglycaemia in a series of 20 infants. Methods and results: Intra‐operative frozen sections were performed on small specimens from the pancreatic head, isthmus and tail. In 13 cases, abnormal B‐cell nuclei were identified, but even a near‐total pancreatectomy was insufficient to cure some of these patients, in whom no focal lesion was detected. On the other hand, abnormal insular B‐cell nuclei were not found in seven cases; based on the results of selective venous catheterization, a limited resection was performed, sufficient to cure each patient, and a focal adenomatous hyperplasia was found in each resected specimen. Conclusions: Intra‐operative examination of small pancreatic specimens taken from the different parts of the gland allows one to determine the type of lesion (focal or diffuse) in neonatal onset hyperinsulinaemic hypoglycaemia, and to decide on the most appropriate surgical treatment.
doi_str_mv 10.1046/j.1365-2559.1998.00326.x
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C ; POGGI, F ; BRUNELLE, F ; NIHOUL-FEKETE, C ; SAUDUBRAY, J. M ; JAUBERT, F</creator><creatorcontrib>RAHIER, J ; SEMPOUX, C ; FOURNET, J. C ; POGGI, F ; BRUNELLE, F ; NIHOUL-FEKETE, C ; SAUDUBRAY, J. M ; JAUBERT, F</creatorcontrib><description>Aims: To determine whether the presence of abnormal B‐cell nuclei predicts the existence of a focal or of a diffuse form of persistent neonatal and infantile hyperinsulinaemic hypoglycaemia in a series of 20 infants. Methods and results: Intra‐operative frozen sections were performed on small specimens from the pancreatic head, isthmus and tail. In 13 cases, abnormal B‐cell nuclei were identified, but even a near‐total pancreatectomy was insufficient to cure some of these patients, in whom no focal lesion was detected. On the other hand, abnormal insular B‐cell nuclei were not found in seven cases; based on the results of selective venous catheterization, a limited resection was performed, sufficient to cure each patient, and a focal adenomatous hyperplasia was found in each resected specimen. Conclusions: Intra‐operative examination of small pancreatic specimens taken from the different parts of the gland allows one to determine the type of lesion (focal or diffuse) in neonatal onset hyperinsulinaemic hypoglycaemia, and to decide on the most appropriate surgical treatment.</description><identifier>ISSN: 0309-0167</identifier><identifier>EISSN: 1365-2559</identifier><identifier>DOI: 10.1046/j.1365-2559.1998.00326.x</identifier><identifier>PMID: 9522211</identifier><language>eng</language><publisher>Oxford, U.K. and Cambridge, USA: Blackwell Science Ltd</publisher><subject>Biological and medical sciences ; Cell Nucleolus - pathology ; Cell Nucleus - pathology ; Chromatin - pathology ; Diagnosis, Differential ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Frozen Sections ; Histocytochemistry ; Humans ; Hyperinsulinism - congenital ; Hyperinsulinism - pathology ; Hyperinsulinism - surgery ; Hypoglycemia - congenital ; Hypoglycemia - pathology ; Hypoglycemia - surgery ; Infant ; infantile hypoglycaemia ; Islets of Langerhans - cytology ; Islets of Langerhans - pathology ; Islets of Langerhans - ultrastructure ; Medical sciences ; Microtomy ; nesidioblastosis ; Pancreas - cytology ; Pancreas - pathology ; Pancreas - surgery ; Pancreatectomy ; Paraffin Embedding ; Prognosis ; Tumors. 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Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Frozen Sections</topic><topic>Histocytochemistry</topic><topic>Humans</topic><topic>Hyperinsulinism - congenital</topic><topic>Hyperinsulinism - pathology</topic><topic>Hyperinsulinism - surgery</topic><topic>Hypoglycemia - congenital</topic><topic>Hypoglycemia - pathology</topic><topic>Hypoglycemia - surgery</topic><topic>Infant</topic><topic>infantile hypoglycaemia</topic><topic>Islets of Langerhans - cytology</topic><topic>Islets of Langerhans - pathology</topic><topic>Islets of Langerhans - ultrastructure</topic><topic>Medical sciences</topic><topic>Microtomy</topic><topic>nesidioblastosis</topic><topic>Pancreas - cytology</topic><topic>Pancreas - pathology</topic><topic>Pancreas - surgery</topic><topic>Pancreatectomy</topic><topic>Paraffin Embedding</topic><topic>Prognosis</topic><topic>Tumors. 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subjects Biological and medical sciences
Cell Nucleolus - pathology
Cell Nucleus - pathology
Chromatin - pathology
Diagnosis, Differential
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Frozen Sections
Histocytochemistry
Humans
Hyperinsulinism - congenital
Hyperinsulinism - pathology
Hyperinsulinism - surgery
Hypoglycemia - congenital
Hypoglycemia - pathology
Hypoglycemia - surgery
Infant
infantile hypoglycaemia
Islets of Langerhans - cytology
Islets of Langerhans - pathology
Islets of Langerhans - ultrastructure
Medical sciences
Microtomy
nesidioblastosis
Pancreas - cytology
Pancreas - pathology
Pancreas - surgery
Pancreatectomy
Paraffin Embedding
Prognosis
Tumors. Hypoglycemia
title Partial or near-total pancreatectomy for persistent neonatal hyperinsulinaemic hypoglycaemia: the pathologist's role
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