Pancreatic Disorders & Therapy
Open Access

Clinical Pathology of Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

Sahim Nawaz^{* *}Correspondence: Sahim Nawaz, Department of Infectious Diseases, University of Buenos Aires, Buenos Aires, Argentina, Email:

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Description

The pancreas is a 6 inch long gland that resembles a slender pear turned on its side. The pancreas is divided into three parts: the head, the body, and the tail, which refers to the thin end. The pancreas is located in front of the spine and behind the stomach. Glandular material and a network of tubes extend across the length of the pancreas analogous to the veins on a lamella. The central duct or main vein of the lamella is called the pancreatic-duct. In addition to the glandular material, there are clusters of tissue, that look like a bunch of grapes, called ‘Islet of Langerhans’ distributed throughout the pancreas.

The pancreas has two different types of cells

Endocrine pancreas cells: Including insulin for blood sugar regulation, are produced by endocrine pancreatic cells (chemicals that regulate the activity of certain cells or organs in the body).The little grouping of all over pancreases islet cells or islets of langerhans are other names for endocrine pancreatic cells. Islet cell tumours, pancreatic endocrine tumours, or pancreatic neuroendocrine tumours are all names for cancers that develop in islet cells (pancreatic NETs).

Exocrine pancreas cells: Enzymes produced by exocrine pancreatic cells are then released into the small intestine to aid in the body's digestion of meals. The majority of the pancreas is composed of ducts that end in tiny sacs that are lined with exocrine cells.

Pancreatic NETs can be active (Functional) or inactive (Non-Functional)

• Hormones such gastrin, insulin, and glucagon are produced in excess by functional (Active) tumours and cause symptoms.

• Hormone production is not increased in tumours that are not functioning (Inactive). The tumor's growth and spread cause signs and symptoms. The majority of benign tumours are malignant (Cancer).

• The majority of pancreatic NETs are active tumours.

Different types of functioning pancreatic NETs

NETs in the pancreas produce a variety of hormones, including glucagon, insulin, and gastrin. The following are examples of functional pancreatic NETs:

Gastrinoma: A gastrinoma is a tumour that develops in the gastrin-producing cells. A hormone called gastrin triggers the stomach to release acidic acid that aids in food digestion. Gastrinomas cause a rise in both gastrin and stomach acid. The Zollinger-Ellison syndrome is characterised by increased stomach acid, stomach ulcers, and diarrhoea brought on by a gastrinproducing tumour. The head of the pancreas is where gastrinomas typically develop, though they can also develop in the small intestine. Almost of gastrinomas are cancerous (cancer).

Insulinoma: A tumor that forms in the cells that produce insulin. Insulin is a hormone that controls the amount of glucose (sugar) in the blood. It transports glucose into cells where the body can use it for energy. Insulinomas are usually slow-growing tumors that rarely spread. An insulinoma forms in the head, body, or tail of the pancreas. Insulinomas are usually benign (not cancer).

Glucagonoma: A tumour that develops in glucagon-producing cells. Glucagon is a hormone that raises the blood glucose level. It causes glycogen breakdown in the liver. Hyperglycemia is caused by an excess of glucagon (high blood sugar). A glucagonoma usually develops in the pancreas' tail. The majority of glucagonomas are cancerous (cancer).

Other types of tumors: Other rare types of functional pancreatic NETs produce hormones, including hormones that regulate the body's sugar, salt, and water balance. Among these tumours are:

• VIPomas are cells that produce vasoactive intestinal peptide. VIPoma is also known as Verner-Morrison syndrome.

• Somatostatinomas are tumours that produce somatostatin.

• These other types of tumours have been grouped together because they are treated in a similar manner.