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Pancreas

Tumors

VIPoma


Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 28 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Also called Verner-Morrison tumors - tumors secrete vasoactive intestinal peptide (VIP)
● 90% of VIPomas arise from pancreas (eMedicine)

Clinical features
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● Diarrhea (cholera-like), hypokalemia, achlorhydria
● Neural crest tumors (ganglioneuroma, neuroblastoma, neurofibroma, pheochromocytoma) and G cell tumors produce similar symptoms
● Also contains pancreatic polypeptide, calcitonin, alpha chain of hCG
● May be locally invasive or metastastic

Case reports
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● 46 year old woman with 18 cm tumor (World J Surg Oncol 2008;6:80)

Gross images
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Pancreatic head tumor


Tumor producing 90% calcitonin, 10% VIP

Micro images
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Interconnecting nests and trabeculae of uniform cuboidal cells with granular cytoplasm and central round nuclei


Tumor producing 90% calcitonin, 10% VIP (left: H&E, right: VIP stain)


Small regular glands are present throughout a malignant VIPoma


Solid arrangement of uniform epithelial cells with faintly stained cytoplasm, interrupted by cystic spaces filled with weakly eosinophilic serum-like material


Trabeculae of epithelial cells with fairly abundant cytoplasm separated by loose stroma; scattered tumor cells show VIP immunostaining

Electron microscopy images
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Small secretory granules in a pancreatic tumor with scattered VIP-immunoreactive cells and associated WDHA syndrome


Cells with a few, round, small granules; well-developed reticulum and Golgi complex; and scattered elongated dense bodies


Abundant secretory granules of variable size, shape, and density in a pancreatic tumor with WDHA syndrome; abundant PP-and a few VIP-immunoreactive cells (inset) were detected by light microscopic immunohistochemistry

End of Pancreas > Tumors > VIPoma


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