c Islet functional beta cell tumor
Introduction
Introduction of c-islet functional beta cell tumor Islet beta cell tumor. It 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. The function of pancreatic islet -cell tumor is slow, and a small number of patients have been diagnosed for a long time. For example, long-term misdiagnosis can cause permanent brain damage. Islet cell tumors are relatively rare, mostly benign and a few malignant. basic knowledge The proportion of illness: 0.03% Susceptible people: no specific population Mode of infection: non-infectious Complications: digestive ulcers, abdominal pain
Cause
c islet functional beta cell tumor etiology
Cause:
It is divided into functional and non-functional categories. Among them, insulinoma is the most common, accounting for 60-90%. The tumor-prone site is the pancreas and tail, which are usually small, mostly less than 2.0cm. 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 tumors are glucagonoma, vasoactive intestinal peptide (vipoma) and somatostatinoma. Non-functional islet cell tumors are usually large, even over 10 cm.
Prevention
c 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.
It is very important to maintain a good attitude, to maintain a good mood, to have an optimistic, open-minded spirit, and to be confident in the fight against disease.
The diet must first choose a nutrient-rich, digestible, less irritating, low-fat diet that can give high-protein, multi-carbohydrate foods.
Complication
c islet functional beta cell tumor complications Complications, digestive tract ulcer, abdominal pain
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.
Symptom
c islet functional beta cell tumor symptoms common symptoms memory disorder hypoglycemia obesity
The onset is slow, and a small number of patients are diagnosed over a long period of time. Long-term misdiagnosis can cause permanent brain damage. Clinical manifestations are:
First, Whipple triad:
1 symptoms of hypoglycemia after hunger or exercise;
2 blood sugar <2.8mmol / L (50mg / dl);
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 a meal. More with the body gradually obese, memory, responsiveness decreased.
Examine
c islet function beta cell tumor examination
1. Blood sugar <2.8mmol/L (50mg/dl) at the time of onset.
2. Serum insulin and C peptide:
Plasma insulin and C-peptide increase in hypoglycemia, insulin index (insulin / blood glucose) > 0.3, such as > 1.0 can be confirmed. Fasting plasma insulin >200uU/ml is definitely a diagnosis.
3. Oral glucose tolerance test:
Typical models are low-level curves, some of which have reduced glucose tolerance, and a few with early hypoglycemia or normal glucose tolerance curves.
4. Hunger test:
Positive is helpful for diagnosis. Only fasting blood glucose >2.8mmol / L can be tested. More than 90% fasting 24-36h can stimulate hypoglycemia. A small number of people need to fast for 48-72h, and exercise 2 hours before the end of fasting, can stimulate hypoglycemia. Those who did not induce hypoglycemia after 72 hours of fasting may be excluded from the disease.
5, regular X-ray:
Gastrinoma patients with digestive tract locks can show multiple gastric and duodenal ulcers.
6, ultrasound performance:
The lesion is in the edge of the pancreas or in the pancreas, round or elliptical, with a low echo in the mass and a clear edge. Malignant islet cell tumors have irregular boundaries and internal echoes are 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, both benign and malignant, are multi-vascular and rich in blood for tumors, so the early enhancement (hepatic artery) mass of the enhanced scan is significantly enhanced with high-density nodules, higher than the surrounding normal pancreas.
(3) Non-functional tumors are usually large, uniform or uneven in density, and occur mostly in the body and tail of the body. About 20% of the tumors are calcified in the tumor. After strengthening, 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 continues to increase, and the clear staining of the tumor is seen to be characteristic.
Diagnosis
Diagnostic identification of c islet functional beta cell tumor
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
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.
