Expression of glycoprotein hormone alpha-subunit by endocrine cells of the oxyntic mucosa is associated with hypergastrinemia

Previous studies have shown that hyperplastic endocrine cells of the oxyntic mucosa in patients with atrophic gastritis may express immunoreactivity for the alpha-subunit of human chorionic gonadotropin (alpha-HCG, common to all glycoprotein hormones). Since this endocrine proliferation is regarded as dependent on the trophic effect of the concomitant hypergastrinemia, the relation between immunohistochemical expression of alpha-HCG by oxyntic endocrine cells and serum levels of gastrin were investigated. The study was performed on endoscopic gastric biopsies of the oxyntic mucosa from 49 patients subdivided into the following groups: A) with histologically normal mucosa and normogastrinemia (22 cases), B) with atrophic gastritis and normogastrinemia (12 cases), C) with normal mucosa and hypergastrinemia (Zollinger-Ellison syndrome, retained antrum) (7 cases) and D) with atrophic gastritis and hypergastrinemia (with or without pernicious anemia) (8 cases). The alpha-HCG immunoreactive cells were found in all hypergastrinemic patients (groups C and D), regardless of the concomitant pathological condition of the mucosa. These cells accounted for 7.8% to 44.7% of the number of Grimelius argyrophil cells in consecutive serial sections. In contrast, alpha-HCG-containing cells were exceptional or absent in most normogastrinemic patients. Their number was sizable in only two cases of group A and three cases of group B, where it ranged from 2.5% to 14.8% of the number of argyrophil cells. It was concluded that expression of alpha-HCG is another feature of oxyntic endocrine cells associated with hypergastrinemia in addition to those previously recognized such as development of hyperplasia and/or carcinoid tumors.

Entero-endocrine cell differentiation in carcinomas of the gallbladder and mucinous cystadenocarcinomas of the pancreas

Forty two carcinomas of the gallbladder and 25 mucinous cystadenocarcinomas of the pancreas were analyzed using silver stains and immunohistochemical techniques. Fourteen (33.3%) gallbladder carcinomas had argyrophil and argentaffin cells and 17 (40%) contained endocrine cells as shown by immunoperoxidase stains. The gallbladder tumors that had the largest number of endocrine cells were the well differentiated adenocarcinomas with colonic features. The most common endocrine cell in these tumors was the serotonin-containing (EC) cell followed by somatostatin-containing cells and cells that reacted to pancreatic polypeptide and gastrin. Intestinal metaplasia with pseudopyloric gland hyperplasia was present in the gallbladder mucosa adjacent to 11 carcinomas and had an endocrine cell population similar to that of the tumors. Endocrine cells were demonstrated in 18 (70%) of the 25 mucinous cystadenocarcinomas of the pancreas by the immunoperoxidase method although only 9 had argyrophil and argentaffin cells. The population of endocrine cells in these mucinous pancreatic tumors was similar to that found in gallbladder carcinomas. Endocrine cells were more numerous in areas with colonic-type glands, goblet cells and Paneth cells. The secretory products of the endocrine cells in these gallbladder and pancreatic tumors did not give rise to systemic endocrine manifestations. The presence of endocrine cells in these tumors can be explained on the basis of intestinal differentiation.

A case of multiple carcinoid tumors of the rectum with extraglandular endocrine cell proliferation

A case of multiple carcinoid tumors of the rectum with numerous proliferations of extraglandular endocrine cells is reported. The patient was 52-year-old man with five polypoid lesions in the rectum. The resected rectum contained five macroscopic carcinoid tumors, 36 microcarcinoids, and innumerous extraglandular endocrine cell proliferations. Endocrine cell microproliferations, in their early stage consisting of one to 15 micronests, were mainly located within the bundles of muscularis mucosae, having no contact with mucosal glandular structures. All of the immunohistochemically examined proliferations of extraglandular endocrine cells contained S-100 protein-positive dendritic cells, and some endocrine cells coexisted with submucosal ganglion cells. In contrast, there was no increase in intraglandular endocrine cells. The origin of rectal carcinoid tumor may be the extraglandular endocrine cells, a distinct compartment of mucosal endocrine cells of the rectum.

Gastric endocrine cell hyperplasia and carcinoid tumors in atrophic gastritis type A

Immunohistochemical, histochemical, and morphometrical studies of six gastric carcinoid tumors and their possible precursor lesions in gastric mucosa are reported. All tumors, presenting successively at our institute, occurred in the corpus mucosa of 45- to 78-year-old patients. Two neoplasms had already metastasized. Three tumors contained gastrin- and/or serotonin-positive cells. Two groups of carcinoids, one with atrophic gastritis type A [AGA (four cases)], and one without AGA (two cases) were discerned. Only cases with AGA showed antral G cell hyperplasia consistently as well as fundic endocrine cell proliferation and sometimes multifocal tumors. This confirms previous reports that hypergastrinemia might be a predisposing condition for the development of gastric carcinoids in AGA. Fundic endocrine cell increase, verified by quantitative methods, was either diffuse or nodular. Diffuse endocrine cell hyperplasia comprised G, EC, and ECl cells. The observation that endocrine cell nodules comprised a similar mixture of endocrine cells, sometimes communicating with glands of pseudopyloric metaplasia and proving to be reversible in one case, provides evidence that these nodules are hyperplastic, but finally may lead to gastric carcinoid tumors in AGA. Size less than 150 micron, basal location, and mixed hormone content may be helpful criteria for the distinction of hyperplastic endocrine cell nodules from small carcinoid tumors.

Quantitative study of pulmonary endocrine cells in anencephaly

Quantitative studies of pulmonary endocrine cells in 8 male autopsy cases of anencephaly were performed. The densities of pulmonary endocrine cells were expressed as the number of the total argyrophil cells/100 bronchiolar cell nuclei and as the number of the total argyrophil cells/mm bronchiole. The average values in the 8 anencephalic cases were 1.26 cells/100 nuclei and 3.56 cells/mm, and did not differ from the 1.28 cells/100 nuclei and 3.24 cells/mm in the control cases without malformation of the brain and without severe hyaline membrane disease of the lung. Furthermore, there was no significant difference in the densities of neuroepithelial bodies between the 2 groups. Immunostaining for calcitonin, bombesin, adrenocorticotropic hormone, chromogranin, and neuron-specific enolase also revealed no qualitative differences between them. It is concluded that defect and hypofunction of the hypothalamus-pituitary-adrenal axes associated with anencephaly do not have significant effects on the proliferation and differentiation of pulmonary endocrine cells in the fetus.

Contributions of immunohistochemical and molecular biological techniques to endocrine pathology

Histochemistry has played a major role in the development and implementation of new methods for analysis of gene expression at the cellular level. With the techniques of immunocytochemistry and in situ hybridization, the products of RNA translation as well as specific messenger RNAs and genomic DNAs can be demonstrated and can provide highly dynamic analyses of gene transcription and translation in individual cells. In endocrine pathology, these approaches have been particularly effective for correlation of functional abnormalities with the varying manifestations of disease at the cellular level. In addition, these methods have been valuable in the formulation of novel clinical and pathological concepts, and will continue to provide important tools for diagnostic and prognostic assessment of neoplastic and non-neoplastic disorders of the endocrine system.

Experimental Argentine hemorrhagic fever in rhesus macaques: virus-specific variations in pathology

Two isolates of Junin virus (Espindola and Ledesma) inoculated into rhesus macaques produced distinct lesions which were strain-constant and similar to reported human cases of Argentine hemorrhagic fever. The Espindola isolate was associated with hemorrhagia, necrosis of bone marrow, and mild hepatocellular necrosis. Ledesma isolate was associated with pronounced polioencephalomyelitis and autonomic ganglioneuritis, but very mild or absent hepatocellular necrosis, bone marrow necrosis, and hemorrhagia. Deaths of Espindola-infected macaques were usually attributed to hemorrhagia with severe secondary bacterial infections, while in Ledesma-infected macaques, death was associated either with early severe secondary bacterial infections or slowly progressive polioencephalomyelitis. These two Junin virus isolates demonstrated hemorrhagic viscerotropism or neurotropism in macaques, suggesting that the variety of Argentine hemorrhagic fever syndromes in man may be virus-isolate determined.

Development of a monoclonal antibody specifically reactive to gastrointestinal goblet cells

A mouse monoclonal antibody (7E6A5) of IgG isotype, reacting specifically with mucin-producing goblet cells of the human gastrointestinal tract, has been developed. 7E6A5 reacts by an ELISA with colonic protein eluted from a DEAE column. A screening by immunoperoxidase assay of 76 specimens from 19 different human tissues showed that the immunoreactivity of 7E6A5 was confined exclusively in the globules of goblet cells in the colon, the appendix, and the small intestine. Nongoblet small and large intestinal epithelial cells did not react. Immunoelectron microscopy demonstrated the reactivity with mucin droplets in a homogeneous granular pattern inside the globules of goblet cells. Mucus-secreting cells from remaining parts of the gastrointestinal tract and other mucus-secreting organs such as respiratory, genitourinary tracts, salivary and mammary glands did not show any reactivity to 7E6A5. These findings indicate that the antigen recognized by 7E6A5 is shared by the goblet cells of both the small and large intestines and is unique to them. The monoclonal antibody may be useful in the study of function of mucus-secreting goblet cells and may represent an important tool in the evaluation of diseases such as ulcerative colitis, colon cancer, and intestinal metaplasia in gastric mucosa that are associated with quantitative changes in goblet cell numbers or with qualitative differences in mucin secretion.

Genetically determined murine models of immunodeficiency

We have discussed more than 30 mutant genes known to cause abnormalities in the development and regulation of the immune system. The loci defined by these deleterious alleles have been assigned to 13 different autosomal chromosomes in addition to X and Y. It is important to note that these single genes do not act alone but function in concert with the background genome. Studies of these mutations on different inbred strain backgrounds are contributing important information on the influence of background modifying genes. The development of stocks of mice carrying multiple mutations on an inbred strain background enables the use of a well-characterized mutation to explore a less-well-understood genetic model. Investigators are urged to assure proper conditions for studies with immunological mutants by using the appropriate methods of animal husbandry. A detailed guide for maintaining immunologically compromised rodents has been prepared. These experiments performed by nature provide a valuable resource for investigating the immune system in normal and pathologic states. As the gene products of the loci defined by these mutations become known, the information obtained will provide additional insight into mechanisms underlying normal immune function as well as immunologic disease processes in man.

Neoplastic endocrine cells in carcinomas of the small intestine: histochemical and immunohistochemical studies of 24 tumors

Endocrine cells in 24 primary carcinomas and in the nonneoplastic mucosa of the small intestine were investigated histochemically and immunohistochemically with antisera against serotonin and 10 kinds of peptide hormones. Argyrophil-positive endocrine cells were found in four of eight duodenal, all of eight jejunal, and six of eight ileal carcinomas. The density of the positive cells was higher in the ileal tumors than in the duodenal and jejunal ones. Immunoreactive endocrine cells were detected in three duodenal, six jejunal, and five ileal carcinomas. Immunoreactive serotonin cells were present most frequently and most densely without respect to the site of origin of the carcinomas. In general, the population of endocrine cells among the tumor cells was higher in the ileal carcinomas than in the duodenal and jejunal ones. The ileal carcinomas frequently and densely demonstrated somatostatin, peptide YY, neurotensin, glucagon, and glicentin cells in addition to serotonin cells. The kinds of endocrine cells and the relative frequency of each kind of endocrine cell in carcinomas of the small intestine were similar to those in the nonneoplastic mucosa from which the carcinomas originated. This is the first systematic immunohistochemical study on endocrine cells in carcinoma of the small intestine.

Increased populations of endocrine cells in Crohn's ileitis

Hyperplasia of nerves has been described previously in Crohn's disease. To determine whether similar alteration of the enteric endocrine system occurs, endocrine cells of the ileal epithelium were quantified in typical cases of the disease. In the ileum from patients with Crohn's disease, there was an increase in the endocrine cell population, as visualised by immunostaining of chromogranin. Quantification of endocrine cell numbers showed significant increases in both macroscopically uninvolved (i.e. histologically normal) (35.0 +/- 3.8, cells per unit length of muscularis mucosae mean +/- SEM, P less than 0.05) and involved (44.5 +/- 5.5, P less than 0.01) Crohn's disease samples, compared with normal controls (23.7 +/- 3.4). Although individual types of endocrine cell showed slight increases in Crohn's samples, only the enterochromaffin cells in abnormal bowel showed a significantly greater population (normal controls 10.5 +/- 2.3; involved Crohn's 21.3 +/- 4.4, P less than 0.05).

Argyrophil cells in the rat duodenum after gastrectomy

Two different techniques of reconstruction after total gastrectomy were performed in rats: Roux-en-Y (RY) and jejunal interposition (JI). Sham-operated rats were used as controls. Sixteen weeks after surgery the animals were sacrificed. The distribution of the enteroendocrine cells in the duodenal and proximal jejunal mucosa was examined using the Grimelius silver nitrate stain. The frequency of the Grimelius-positive cells was estimated as number of cells per square millimeter of gut surface and as number of cells per transverse section of intestine. Intestinal villi height was also measured in the same duodenojejunal tracts. After gastrectomy, the JI rats showed a better weight gain than RY rats (p less than 0.05). A significant difference in the distribution of intestinal argyrophil cells was seen. The bypassed duodenojejunal tracts in RY rats showed a marked reduction of the Grimelius-positive cells in comparison with JI rats and controls (p less than 0.01). A reduction in the number of argyrophil cells in the proximal duodenum was also noticed in the JI rats in comparison with controls (p less than 0.01). A decrease in the villi height resulted in all the gastrectomized rats (p less than 0.01), but a significant decrease was also noticed in RY rats in comparison with JI (p less than 0.01). Our experimental observations suggested that the exclusion of the duodenum from intestinal transit after gastrectomy caused atrophy of the gut mucosa and a marked reduction in the number of argyrophil enteroendocrine cells in the bypassed tracts.

Tubular adenoma of the human stomach. An immunohistochemical analysis of gut hormones, serotonin, carcinoembryonic antigen, secretory component, and lysozyme

A total of 49 gastric tubular adenomas and 6 tubular adenomas with foci of adenocarcinoma from surgically resected stomachs were examined histologically and immunohistochemically for gut peptide hormones, serotonin, carcinoembryonic antigen (CEA), secretory component (SC), and lysozyme. A variety of endocrine cells were detected in tubular adenoma with mild to moderate atypia. Both the frequency and distribution density were highest for serotonin-containing EC cells, often showing hyperplasia, followed by glicentin-containing L cells, somatostatin-containing D cells and motilin-containing Mo cells in the order given. Adenoma cells with SC immunoreactivity were more dominant than those with CEA immunoreactivity. In tubular adenoma with severe atypia, endocrine cells were markedly decreased, whereas adenoma cells with CEA immunoreactivity were increased. The distribution density of lysozyme-containing cells in tubular adenoma of the intermediate zone and fundus was significantly higher than that of the antrum. In the subjacent mucosa of the adenoma, L cells and SC-positive epithelial cells were detected in 24 and 33 cases, respectively. These findings suggest that gastric tubular adenoma develops from intestinal metaplasia. In addition, gastric tubular adenoma showed a tendency to lose various intestinal markers with increase of histologic atypicality.

Tubular adenoma of the human stomach. An immunohistochemical analysis of gut hormones, serotonin, carcinoembryonic antigen, secretory component, and lysozyme

A total of 49 gastric tubular adenomas and 6 tubular adenomas with foci of adenocarcinoma from surgically resected stomachs were examined histologically and immunohistochemically for gut peptide hormones, serotonin, carcinoembryonic antigen (CEA), secretory component (SC), and lysozyme. A variety of endocrine cells were detected in tubular adenoma with mild to moderate atypia. Both the frequency and distribution density were highest for serotonin-containing EC cells, often showing hyperplasia, followed by glicentin-containing L cells, somatostatin-containing D cells and motilin-containing Mo cells in the order given. Adenoma cells with SC immunoreactivity were more dominant than those with CEA immunoreactivity. In tubular adenoma with severe atypia, endocrine cells were markedly decreased, whereas adenoma cells with CEA immunoreactivity were increased. The distribution density of lysozyme-containing cells in tubular adenoma of the intermediate zone and fundus was significantly higher than that of the antrum. In the subjacent mucosa of the adenoma, L cells and SC-positive epithelial cells were detected in 24 and 33 cases, respectively. These findings suggest that gastric tubular adenoma develops from intestinal metaplasia. In addition, gastric tubular adenoma showed a tendency to lose various intestinal markers with increase of histologic atypicality.

Glandular lesions of the uterine cervix: the present state of our knowledge

The assessment of squamous lesions of the uterine cervix is a major preoccupation of diagnostic histopathologists and this can overshadow the recognition of significant abnormalities affecting the adjacent endocervical glands. This review gives an account of recent advances in our knowledge of the histology and histochemistry of endocervical glands. The review of benign lesions concentrates on those that continue to cause diagnostic difficulty. Adenocarcinoma in situ, lesser degrees of possibly pre-malignant cervical glandular atypia and histological subtypes of adenocarcinoma are outlined. The increasing awareness that glandular and squamous lesions often co-exist is emphasized. Finally, adenocarcinoma metastatic to the cervix is discussed.

Naturally occurring lesions in some endocrine glands of laboratory maintained baboons (Papio sp.)

The pituitary gland was examined from 623 immature baboons (Papio cynocephalus and Papio anubis). Findings included microscopic cysts in the pars distalis (132), pars intermedia (two) and pars nervosa (one). In 641 necropsies five cases of unilateral thyroid glands were noted. Microscopic thyroid lesions included ectopic thymus (328), minor lymphocytic infiltrates (14) and cysts (two). Parathyroid lesions consisted of ectopic thymus (73) and cysts (24). Dilated capillaries in the islets of Langerhans was the only microscopic change seen in the endocrine pancreas. All lesions generally occurred in both untreated control and treated baboons at similar incidences. They were considered to be naturally occurring, a part of the "background" pathology of these endocrine glands in immature baboons.

Enteroendocrine cell hyperplasia, carcinoid tumours and adenocarcinoma in long-standing ulcerative colitis

Chronic ulcerative colitis may be accompanied by a variety of epithelial changes, including loss of goblet cells, Paneth cell metaplasia, villous metaplasia, and dysplasia. Total colitis is also accompanied by an increased incidence of adenocarcinoma. All these changes are assumed to be secondary to repeated mucosal damage, but how they develop is unknown. Little attention has been paid to the enteroendocrine cell population, despite the postulated role of these cells as producers of trophic hormones. We describe two patients with long-standing ulcerative colitis who developed both adenocarcinoma and carcinoid tumours. In both, there were increased numbers of enteroendocrine cells in the uninvolved colonic mucosa. We suggest that an increased enteroendocrine cell mass may be part of a non-specific reaction to chronic mucosal injury, and by producing an elevated level of trophic hormones may act as a promoter in the development of neoplasia.

Relations between circulating gastrin and endocrine cell proliferation in the atrophic gastric fundic mucosa

It has been suggested that gastrin may be a causative factor in the proliferation of gastric fundic mucosal endocrine cells, as seen in the Zollinger-Ellison syndrome and in atrophic gastritis with hypergastrinemia of antral origin. In the present study, morphometrically determined densities of endocrine cells in fundic mucosal biopsy specimens were related to basal levels of serum gastrin in 10 normal controls and 60 patients with achlorhydric fundic atrophic gastritis, of which 45 had pernicious anemia (5 with fundic mucosal carcinoid) and 15 had atrophic gastritis without pernicious anemia. The densities of fundic mucosal endocrine cells were positively related to the levels of serum gastrin (atrophic gastritis, rs = 0.65; atrophic gastritis and normal controls, rs = 0.72). The highest levels of serum gastrin were found in patients with carcinoid tumors (mean, 1659.3 pmol/l), followed by those in patients with focal hyperplasias (cluster formation) of endocrine cells (mean, 503.2 pmol/l) and those in patients without focal hyperplasias (mean, 304.4 pmol/l) (p = 0.03 and p = 0.04, respectively).

Unusual endocervical polypoid tumor with endocrine cells: an immunohistochemical and ultrastructural analysis

Light microscopic, immunohistochemical, and ultrastructural features of an unusual polypoid tumor of endocervix are reported. Numerous polypeptide hormone and amine-producing endocrine cells were disclosed. Main conventional characteristics were the architectural growth pattern, with infolding glands giving rise to small secondary glands, the hypermucinous benign-appearing epithelium of endocervical type, and, possibly, the stromal smooth muscle. Ultrastructural analysis showed a highly differentiated tumor. Glandular elements were surrounded by a basal lamina. Mucinous cells, several endocrine cell types, amphicrine cells, nonsecretory ciliated cells, ciliated mucinous cells, and possible reserve cells were observed. This tumor departs appreciably from normal mucosa and common varieties of endocervical polyp, particularly its distinctive endocrine profile. The present case does not correspond to a well-defined type of endocervical neoplasia. It shares morphologic analogies with mucinous tumor of ovary. The malignant potential of this lesion as well as its relationship with minimal deviation adenocarcinoma remain questionable.

A pilot study in adult rhesus monkeys (M. mulatta) treated with Aroclor 1254 for two years

Aroclor 1254, at a dose level of 280 micrograms/kg body weight equivalent to 200 micrograms/kg/day, was given 5 days per week to rhesus monkeys over a 27 to 28 month period. Terminal clinical signs of varying severity included fingernail detachment, exuberant nail beds, weight loss, stomatitis and normocytic anemia. At necropsy the bone marrow was hypocellular with increased M:E ratio and cytoplasmic vacuoles in erythroid precursor cells. Histopathologic lesions included dilatation of the tarsal gland ducts, atrophy or absence of splenic and lymph node germinal centers, bone marrow depletion, gingival erosion and ulceration, moderate mucinous hypertrophic gastropathy with cystic dilatation of occasional gastric glands, hepatocellular enlargement and necrosis, hypertrophy of biliary duct epithelium, hyperplasia of biliary ducts, hypertrophy of the gall bladder epithelium, and an equivocal increase in the number of lysosomes in thyroid follicular epithelial cells. PCB tissue concentrations were lowest in brain and highest in blood. The results suggest that severe potentially fatal PCB toxicity can develop in rhesus monkeys following ingestion of Aroclor 1254 at 200 micrograms/kg/day for a period of 27 months or longer.

Endocrine cells in adenocarcinomas and their prestages in the glandular stomach and duodenum of rats after MNNG administration. Histochemical, electron microscopical and radioimmunological studies

Tumours of the glandular stomach and upper small intestine were induced in rats by oral administration of MNNG. In most cases the lesions were identified histologically as adenocarcinomas and their prestages, such as polypeous and downward growing adenomatous hyperplasias. Out of 48 adenomatous hyperplasias and adenocarcinomas of the stomach and 24 well differentiated adenocarcinomas of the small intestine, we observed argyrophilic cells in nearly the half of the cases. Endocrine cells were also identified by electron microscopy. The frequency of endocrine cells was reduced with decreasing degree of tissue differentiation. In poorly differentiated carcinomas, including signet ring cell carcinomas, no argyrophilic cells were found. Out of 10 adenomatous hyperplasias and tumours of the stomach investigated immunohistochemically, 5 cases showed gastrin producing cells. Most of these animals were radioimmunologically characterized by strongly elevated serum gastrin levels. Derivation and potential relevance of the endocrine cells in tumours are discussed.

Suppression of normal and preneoplastic mammary growth and uterine adenomyosis with reduced growth hormone level in SHN mice given monosodium glutamate neonatally

As a step in the evaluation of the role of growth hormone (GH) in mammary tumorigenesis, the effects of neonatal treatment with monosodium glutamate (MSG) on normal and neoplastic mammary growth, plasma levels of GH and prolactin (PRL) and the pattern of estrous cycles were determined in SHN virgin mice. The development of uterine adenomyosis, which is under similar hormonal control, was also examined in these mice. The formation of precancerous mammary hyperplastic alveolar nodules (HAN) was markedly inhibited and the number of 'ghosts', the remnants of regressed HAN, was increased by the single injection of 4 mg MSG on the day of birth, although spontaneous mammary tumorigenesis was not inhibited. The incidence of adenomyosis was suppressed by MSG treatment. Plasma GH level was chronically lower in the MSG-treated mice than in the controls. In contrast, plasma PRL levels and the pattern of estrous cycles were little affected by the treatment. These results indicate an involvement of GH in the development of HAN and uterine adenomyosis in mice.

The endocrine glands in Pompe's disease. Report of two cases

Pompe's disease (type II glycogenosis), an infantile form of generalized glycogenosis, is characterized biochemically by deficiency of lysosomal acid alpha-1,4-glucosidase and morphologically by intralysosomal glycogen storage in multiple organs, notably the central nervous system, heart, liver, and skeletal muscles. The endocrine system has not been described in detail in the literature. In two infants with Pompe's disease, intralysosomal glycogen was identified in the adrenal cortex and medulla, thyroid gland, parathyroid glands, pancreatic islets, and pituitary gland. Of special interest is the severe glycogen accumulation in the zona fasciculata of the adrenal glands.