Sporadic versus hereditary gastrinomas of the duodenum and pancreas: Distinct clinico-pathological and epidemiological features

Figure 1 Overview of sporadic gastrinomas less than 3 mm in size within the submucosa stained with hematoxylin and eosin (A) and gastrin (B).

Figure 2 Morphology of sporadic duodenal gastrinoma stained with HE showing a trabecular and glandular growth pattern (A); strong immunoreactivity for gastrin (B), and expression of the nuclear proliferation antigen MIB1 in more than 2% of NET cells (C).

Figure 3 Overview of sporadic pancreatic gastrinoma surrounded by thickened collagen in the vicinity of normal pancreatic parenchyma stained with hematoxylin and eosin (A) and gastrin (B).

Figure 4 Circumscribed linear and nodular hyperplasia of gastrin cells within the Brunner’s glands in a patient with MEN1.

Figure 5 Tiny MEN1-associated duodenal gastrinoma within the submucosa revealing a diameter of less than 1 mm.

Figure 6 Duodenal NETs in the Kiel tumor archive. Fifty-nine (76.6%) out of the 77 NETs were endocrinologically not active, 20 of them expressed gastrin. These were not associated with ZES. All the functionally active NETs (18; 23.4%) were immunohistochemically positive for gastrin and showed a ZES.

Figure 7 Pancreatic NETs in the Zürich tumor archives. Seventy-five (49.3%) out of the 152 pancreatic NETs were endocrinologically not active, of which 3 expressed gastrin. These 3 gastrin-expressing NETs were not associated with ZES. Eight of the 77 functionally active NETs were immunohistochemically positive for gastrin and associated with ZES.

Figure 8 Pancreatic NETs in the Kiel tumor archives. Two hundred and twenty-five (58.7%) out of the 383 pancreatic NETs were endocrinologically not active. These gastrin-expressing NET were not associated with ZES. Sixteen of the 158 functionally active NETs were immunohistochemically positive for gastrin and showed a ZES.