1986 Volume 25 Issue 4 Pages 737-740
The hitherto reported number of studies on the cytology of the glucagonoma is extremely rare. Recently we have succeeded in making an identification of the glucagonoma through having performed a peroxidase anti-peroxidase (PAP) method immunocyto-chemical stain on an ascites of a glucagonoma patient by using an antiglucagon (monoclonal antibody). Here follows the report on the above diagnostic record.
The patient was a 71 year old Japanese woman who complained an abdominal tumor with a showing of an abnormally high blood sugar level who was then hospitalized. The tumor biopsy and ascites specimens had been collected while observing the process by use of an ultrasonic wave multiscanner. With the ascites smear specimen obtained through a Papanicolaou (Pap.) stain,
numerous papillary cell clusters were observed mixing with a large quantity of blood cells and mesothelial cells. Pleomorphic and neoplastic findings were observed with the nuclei, such as a marked anisonucleosis, coarse granular chromatin, and/or a prominent nucleoli etc. It was observed that there were existing materials (glucagon) in the lace-like shaped cytoplasms that could be stained by the anti-glucagon, and eventually the patient was diagnosed as suffering from a glucagonoma. The patient died on the tenth day after her hospitalization, and the autopsy was duly conducted. The tumor was a moderately differentiated tubular adenocarcinoma, and this could be stained by using an antiglucagon to eventually be diagnosed as a glucagonoma.
We cultured this pancreatic tumor and measured the glucagon levels in conditioned media. The cultures were characterized as produced glucagon in vitro.
As has been evidenced by the above example, we now can state positively that the immunocyto-chemical stain through the use of a monoclonal anti-glucagon is useful for making an identification of a glucagonoma in conducting a cytological and histological diagnosis.
