[The Verner-Morrison syndrome. The clinical picture and pathologic anatomy]

Multiple endocrine neoplasia type 1

Combined clinical and laboratory investigations of MEN-1 have resulted in an increased understanding of this disorder, which may be inherited as an autosomal dominant condition. Defining the features of each disease manifestation in MEN-1 has improved patient management and treatment and has facilitated a screening protocol. Application of the techniques of molecular biology has enabled the identification of the gene causing MEN-1 and the detection of mutations in patients. The protein encoded by the MEN1 gene has been shown to be involved in the regulation of JunD-mediated transcription, but much still remains to be elucidated. Recent advances permit the identification of mutant MEN1 gene carriers who are at a high risk for this disorder and who require regular and biochemical screening to detect the development of endocrine tumors.

Multiple endocrine neoplasia syndromes

The multiple endocrine neoplasia (MEN) syndromes are characterized by autosomal dominant inheritance with a high degree of penetrance but varying expression. This review gives a classification of these syndromes and a short summary of the historical background. The pathogenesis of the disease and its possible origin in the APUD cell system are discussed together with the mechanisms underlying normal and ectopic hormone production by MEN tumors on the basis of recent findings in molecular endocrinology. The natural history and the clinical manifestations of the different syndromes are described. The sensitivity and discriminative capacity of the tests used to detect the syndromes in an early stage are compared. The choice of therapy and criteria for the timing and extensiveness of treatment are also considered. Lastly, problems associated with the ethical and legal aspects of screening, central registration, and monitoring of relatives at risk are described.

[The endocrine cells of the digestive system (author's transl)]

Endocrine cells occur in the digestive system as micro-organs (islets of Langerhans) or scattered throughout the epithelium of the gastrointestinal tract ("diffuse endocrine epithelial organ" of Feyrter). These gastro-entero-pancreatic (GEP) endocrine cells synthesize--in addition to serotonin--a great variety of polypeptide hormones, which regulate both carbohydrate metabolism and digestive processes. The present review deals mainly with cytology and cytochemistry of GEP endocrine cells. A synopsis is presented of the 19 endocrine cell types identified to date, which includes their update nomenclature and their anatomical distribution pattern. Morphological-functional aspects of cell biology, pathology, and cytogenesis of theses cells and their position within superimposed systems (APUD cells, paraneurons) are discussed.

[Diarrhea and islet cell tumor. Clinical and morphological report on 2 observations]

The combination of diarrhea with an islet cell tumor (Verner-Morrison Syndrome) is a clinical picture presenting many diagnostic problems. It is probable that larger numbers of cases will be encountered with more widespread knowledge of this disease. The clinical features and the pathologic-anatomical findings of two characteristic cases are reported and discussed.