gastrins and Bronchial-Neoplasms

Topics: Acromegaly; Adenoma, Islet Cell; Adrenocorticotropic Hormone; Bronchial Neoplasms; Diabetes Mellitus; Gastrins; Glucagon; Growth Hormone; Humans; Hypoglycemia; Neoplasms; Pancreatic Neoplasms; Somatostatin; Thyrotropin; Zollinger-Ellison Syndrome

Multiple Endocrine Neoplasia type 1 syndrome (MEN1) is characterized by the presence of tumors in parathyroid glands, anterior pituitary gland, endocrine pancreas and duodenum. However, other tumors may also occur. One of them is the carcinoid tumor, which in this context, is more common in the gastrointestinal tract. Less common is the presence of carcinoid tumors of bronchial origin, which with histologic confirmation, may occur in 5-8% of cases and that appears more frequently in patients with hypergastrinemia. We report a patient with MEN1 syndrome, hypergastrinemia and an incidental finding in a somatostatin receptor scintigraphy of an unsuspected bronchial carcinoid tumor that was confirmed histologically.

Topics: Adult; Bronchial Neoplasms; Carcinoid Tumor; Gastrins; Humans; Incidental Findings; Male; Multiple Endocrine Neoplasia Type 1; Neoplasms, Multiple Primary; Radionuclide Imaging; Receptors, Somatostatin

The presence of a number of regulatory peptides (bombesin, gastrin, glucagon, somatostatin, calcitonin and ACTH) was compared in 30 typical carcinoid tumours and 27 well differentiated neuroendocrine carcinomas (atypical carcinoids) using conventional immunocytochemistry. Strong immunostaining for one or more peptide was observed in 97% of the typical carcinoids (29/30) whereas only 67% of the neuroendocrine carcinomas showed immunoreactivity. The peptide most frequently detected in typical carcinoids was bombesin (67%), while gastrin was more common in neuroendocrine carcinomas (44%). Immunoreactivity for more than one peptide was present in 33 tumours and in three cases, six different peptides were detected. The study shows that immunoreactivity to various peptides is more common in typical carcinoids than well differentiated neuroendocrine carcinomas. The significance of these findings is discussed.

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Antibodies, Monoclonal; Bombesin; Bronchial Neoplasms; Calcitonin; Carcinoid Tumor; Female; Gastrins; Glucagon; Humans; Immunoenzyme Techniques; Male; Middle Aged; Peptides; Somatostatin

Topics: Bombesin; Bronchial Neoplasms; Carcinoid Tumor; Carcinoma, Small Cell; Chorionic Gonadotropin; Diagnosis, Differential; Female; Gastrin-Releasing Peptide; Gastrins; Humans; Immunoenzyme Techniques; Lung Neoplasms; Middle Aged; Peptides; Phosphopyruvate Hydratase

A series of 25 apudomas of the gastrointestinal tract (22 cases), bronchus (2 cases), and thymus (1 case) were subjected to staining with silver impregnation (Masson-Fontana and Grimelius) techniques and with the commercial immunoperoxidase kits for the peptide hormones adrenocorticotropin, calcitonin, gastrin, glucagon, growth hormone, human chorionic gonadotropin (hCG), insulin, somatostatin, and vasoactive intestinal peptide. Of the tumors studied, 16 were regarded as malignant, and 5 of the patients showed clinical symptoms due to inappropriate hormone secretion. A total of 16 tumors contained cells positive for 1 or more (6 were multihormonal) of the hormones studied. One bronchial carcinoid stained for hCG, which has not been previously reported. In addition, one of the rectal carcinoids contained somatostatin-positive cells, only once described previously. The thymic tumor proved frankly malignant, most probably identical to the oat-cell carcinoma recently described. The findings also substantiate the recent suggestion that gastrointestinal carcinoids cannot be adequately classified on the basis of silver stains only and strongly advocate the use of the immunoperoxidase kits in routine assessments of all the endocrinologically active tumors, whatever their localization might be.

Topics: Adrenocorticotropic Hormone; Adult; Aged; Apudoma; Bronchial Neoplasms; Calcitonin; Chorionic Gonadotropin; Female; Gastrins; Gastrointestinal Neoplasms; Glucagon; Growth Hormone; Humans; Immunoenzyme Techniques; Male; Middle Aged; Peptides; Somatostatin; Thymus Neoplasms; Vasoactive Intestinal Peptide

Gastro-entero-pancreatic (GEP) and bronchial endocrine tumours have been studied by immunohistochemistry using specific antisera against a variety of hormonal and neuronal peptides. In gastrinomas numerous tumour cells were found to contain GH-like immunoreactivity. These cells were identical with those storing gastrin. Gastrinomas as a rule were extremely heterogeneous containing a variety of minority cell populations, including CCK immunoreactive cells and neurotensin immunoreactive cells. Glucagonoma cells were found to store GIP-like material in addition to glucagon. In some insulinomas calcitonin-like material was encountered in the insulin producing tumour cells. In both glucagonomas and insulinomas other pancreatic endocrine cell types constituted minority cell populations. One intestinal somatostatinoma contained gastrin cells as a minority cell population. Bronchial endocrine tumours contained scattered cells displaying ACTH-like or enkephalin-like immunoreactivity. Two such tumours in addition contained cells displaying neurophysin immunoreactivity.

Topics: Adenoma, Islet Cell; Adrenocorticotropic Hormone; Bronchial Neoplasms; Cholecystokinin; Enkephalins; Fluorescent Antibody Technique; Gastrins; Glucagon; Growth Hormone; Humans; Insulin; Insulin Secretion; Neurophysins; Pancreatic Neoplasms; Serotonin; Somatostatin; Stomach Neoplasms; Zollinger-Ellison Syndrome

Topics: Aged; Blood Glucose; Bronchial Neoplasms; Carcinoma; Coronary Disease; Gastrins; Humans; Insulin; Liver Cirrhosis; Middle Aged; Osteochondritis; Peptides