Quantitative ultrastructure of endocrine cells of oxyntic mucosa in Zollinger-Ellison syndrome. Correspondence with light microscopic findings.
The endocrine cells of the oxyntic mucosa of five patients with longstanding Zollinger-Ellison syndrome were quantitatively investigated with electron microscopy and two light microscopic methods (Grimelius and immunostaining for chromogranin A). Ultrastructurally, the volume density of endocrine cells was 3.2% +/- 1.1% of the mucosal epithelial component, a 168% increase (P less than 0.001) over the value found in normal subjects. Of the six endocrine cell types of human oxyntic mucosa, only enterochromaffinlike cells increased in cell density (65% +/- 15% of the total endocrine cell mass), size, and number of cell profiles per unit area. The enterochromaffinlike cells also underwent morphological changes of secretory granules with a decrease in vacuolated forms, increase in elongated profiles, and appearance of granules with a punctate structure of the core. The latter variety of granules was previously observed only in carcinoid tumors of the oxyntic mucosa and is possibly related to the enterochromaffinlike cell hyperplasia-neoplasia sequence seen in hypergastrinemic patients. A positive relationship was found between endocrine cell densities evaluated ultrastructurally and with chromogranin A immunostaining. It is concluded that in Zollinger-Ellison syndrome, the trophic effects induced by longstanding hypergastrinemia are strictly selective for enterochromaffinlike cells and are associated with ultrastructural features typical for enterochromaffinlike cell tumors.
D'Adda
T
T
Institute of Pathological Anatomy, University of Parma, Italy.
Corleto
V
V
Pilato
F P
FP
Baggi
M T
MT
Robutti
F
F
Delle Fave
G
G
Bordi
C
C
D000328:Adult; D002864:Chromogranins / Q000648:ultrastructure; D003594:Cytoplasmic Granules / Q000648:ultrastructure; D004759:Enterochromaffin Cells / Q000648:ultrastructure; D005260:Female; D005755:Gastrins / Q000097:blood; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008853:Microscopy / Q000379:methods; D008854:Microscopy, Electron; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000648:ultrastructure*; D014617:Vacuoles / Q000648:ultrastructure; D015043:Zollinger-Ellison Syndrome / Q000473:pathology*
D002864:Chromogranins; D005755:Gastrins