Final Diagnosis -- Incidental Glucagonoma (Liver Transplant)
- FINAL DIAGNOSIS:
- PART 1: ALLOGRAFT LIVER (1620 GRAMS), ORTHOTOPIC LIVER
- TRANSPLANTATION -
- A. MASSIVE COAGULATIVE NECROSIS EXTENSIVELY INVOLVING
- HEPATIC PARENCHYMA (microbial stains to follow).
- B. PORTAL VEIN AND HEPATIC ARTERIAL THROMBOSIS.
- C. STATUS POST CHOLECYSTECTOMY.
- PART 2: DISTAL PANCREAS, PARTIAL RESECTION -
- A. PANCREAS WITH FOCAL AREAS OF HEMORRHAGE AND FAT
- NECROSIS (microbial stains to follow).
- B. SPLENIC VEIN AND ARTERIAL THROMBOSIS.
- C. INCIDENTAL ISLET CELL ADENOMA (0.2 CM DIAMETER).
- PART 3: ALLOGRAFT LIVER, RIGHT LOBE, NEEDLE BIOPSY -
- A. MILD CENTRILOBULAR HEPATOCELLULAR NECROSIS.
- B. NO EVIDENCE OF ACUTE CELLULAR REJECTION AND NO
- VIRAL INCLUSIONS SEEN.
- PART 4: ALLOGRAFT LIVER, LEFT LOBE, NEEDLE BIOPSY -
- A. COAGULATIVE HEPATOCELLULAR NECROSIS INVOLVING
- APPROXIMATELY 50% OF THE SAMPLED PARENCHYMA.
- B. NO EVIDENCE OF ACUTE CELLULAR REJECTION AND NO
- VIRAL INCLUSIONS SEEN.
ADDENDUM #2
(1 Chromogranin, 1 Synaptophysin, 1 Insulin, 1 Somatostatin, 1
Glucagon)
Immunohistochemical evaluation of the islet cell microadenoma
reveals positive immunostaining with synaptophysin, chromogranin,
and glucagon with negative reactions with insulin and
omatostatin. These results are consistent with an incidental
"glucagonoma".