Abstract
Hyperplasia of the islet cells of Langerhans is a rare disease associated with hypoglycemic episodes. We report a case of this disease. The patient was a 31-year-old man who was admitted to our hospital because of frequent hypoglycemic episodes. He was diagnosed as having hyperinsulinemia, but various imaging examinations did not disclose any neoplasm, although an increase in immunoreactive insulin was detected in the pancreas body and tail by sampling with percutaneous transhepatic portal vein catheterization (PTC). Although a precise preoperative diagnosis was not obtained, distal pancreatectomy was performed under the suspicion of insulinoma in the pancreas body and tail. The final diagnosis was made pathologically as hyperplasia of the islet cells of Langerhans. No hypoglycemic episodes have occurred during the follow-up period of 2 years. For deciding the extent of pancreatectomy, preoperative sampling by PTC and recognition of intraoperative hyperglycemic rebound were useful.
