@article{oai:kanazawa-u.repo.nii.ac.jp:00013792,
 author = {塩澤, 邦久 and 北川, 裕久 and 中村, 慶史 and 西村, 元一 and 藤村, 隆 and 萱原, 正都 and 清水, 康一 and 太田, 哲生 and 三輪, 晃一 and 野々村, 昭孝},
 issue = {12},
 journal = {日本消化器外科学会雑誌 = The Japanese journal of gastroenterological surgery},
 month = {Nov},
 note = {49歳の男性.1990年検診で高血糖を指摘されていた.2000年4月頃より体重減少(5kg/6か月)を認め,近医受診したところ膵腫瘍を指摘され当科入院となった.入院時,耐糖能障害,血中グルカゴン高値を認め,CT検査にて膵体尾部に複数個の腫瘍を,血管造影では同部位に腫瘍濃染像を認めた.以上より,グルカゴノーマを疑い膵体尾部切除を行った.腫瘍は膵体尾部に3個((1)〜(3))存在した.病理所見では,腫瘍周囲に脈管浸潤を認め悪性と診断した.免疫染色では(1)はグルカゴン陽性,膵ポリペプチド陽性,ほかの膵ホルモン陰性,(2)はグルカゴン弱陽性,他の膵ホルモン陰性,(3)はグルカゴン強陽性,他の膵ホルモン陰性であった。いずれの腫瘍もグルカゴンを産生していたがグルカゴン産生および膵ポリペプチド産生に差異がみられたため,多中心性発生した悪性グルカゴノーマが疑われた.術後経過は順調で,血中グルカゴンも完全に正常化した. A 49-year-old, man diagnosed with hyperglycemia during a physical checkup in 1990 began losing weight in April 2000, dropping 5 kg in 6 months. He was diagnosed elsewhere with a pancreatic tumor and was referred to our department and admitted. On admission, we noted oxyhyperglycemia and hyperglucagonemia. Computed tomography (CT) showed multiple tumors in the pancreatic body and tail. Angiography showed hyperdense masses, suggesting tumors in the same lesion. Based on these findings, he was suspected of glucagonoma and underwent resection of the pancreatic body and tail. Three tumors detected in the pancreatic body and tail were removed tissue and vascular invasion was seen pathologically around the tumors, which were judged to be malignant. Tumor No. 1 tested positive in immunostaining for both glucagon and pancreatic polypeptide, Tumor No. 2 weakly positive for glucagon, Tumor No. 3 strongly positive for glucagon. All 3 tested negative for other pancreatic hormones. Although all were glucagon-producing, they differed in the production of other pancreatic hormones, and were thought as multicentric malignant glucagonoma. The postoperative course was uneventful, and blood glucagon normalized after surgery.},
 pages = {1788--1792},
 title = {多中心性発生が疑われた悪性グルカゴノーマの1例},
 volume = {35},
 year = {2002}
}