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- Title
Granulomatous Insulitis as a Cause of Acute-Onset Insulin-Dependent Diabetes Mellitus in a Patient With a Pancreatic Endocrine Carcinoma.
- Authors
Saab, Jad; Qin, Lihui; Jessurun, Jose
- Abstract
Autoimmune destruction of β cells is the cause of most cases of type 1 diabetes mellitus. Lymphocytic insulitis has been documented in the early phases of this disease as well as in recurrent diabetes after pancreas transplantation and in certain viral infections. We report a unique case of granulomatous insulitis in a patient with an endocrine tumor of the pancreas that clinically manifested as acute-onset insulin-dependent diabetes mellitus. Granulomata were present in islets with complete disappearance of β cells, as well as in the primary tumor, metastases, and lymph nodes. We postulate that these granulomata represent a sarcoid-like reaction to the tumor with secondary injury to nonneoplastic endocrine cells through a mechanism of molecular mimicry.
- Subjects
TYPE 1 diabetes; ENDOCRINE gland tumors; PANCREATIC beta cells; ETIOLOGY of diabetes; PANCREATIC cancer; AUTOIMMUNE diseases
- Publication
International Journal of Surgical Pathology, 2016, Vol 24, Issue 7, p648
- ISSN
1066-8969
- Publication type
Case Study
- DOI
10.1177/1066896916648770