43-year-old male, Zollinger-Ellison syndrome with 2 duodenal ulcers, partial resection of pancreas and duodenum 4 years previously. In the duodenum a neuroendocrine tumour with gastrin production, in the pancreas a further tumour with few gastrin cells. For some months enlarged liver caused by metastases (confirmed by CT).
- Liver parenchyma
- Multiple nodules of a partly solid, partly adenomatous tumour separated by thin septa
- Low-grade cell and nuclear polymorphism
- Few mitoses
- Many tumour cells show a distinct reaction to chromgranin A.
gastrinomas often lie in the duodenum and can be so small that they may be missed in endoscopical investigations.