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The Korean Journal of Pathology 1992;26(5): 484-489.
Nesidioblastosis of the Pancreas.
Young Bae Kim, Jin Sook Jeong, Ahn Hong Choi
1Department of Pathology, Dong-A University College of Medicine, Pusan, Korea.
2Department of Pediatrics, Dong-A University College of Medicine, Pusan, Korea.
The morphologic abnormalities of the endocrine pancreas that underlie persistent neonatal hyperinsulinemic hypoglycemia and are included under the heading "nesidioblastosis" appears to be heterogeneous. This characteristic morphologic finding is ductuloinsular complexes showing endocrine cells budding off the ductoepithelium and merging with adjacent endocrine cell clusters. A case of nesidioblastosis associated with hyperinsulinemic hypoglycemia occurred in a 6/365 year-old male neonate. Microscopic finding of near totally resected pancreas revealed irregular sized islets and ductuloinsular complexes, both of which contained hypertrophied B cells with a few mitosis. Because of persistent hypoglycemia after first operation, he received second operation 8 days after. This histologic finding was more severe comparative to that of first operation. According to these findings, the pathogenesis of nesidioblastosis may be congenital or developmental defect of a kind of compensatory mechanism by unknown stimuli to acquire persistent hypoglycemia.
Key Words: Pancreas; Persistent neonatal hypoglycemia; Nesidioblastosis; Pathogenesis