On the relation of chronic interstitial pancreatitis to the islands of Langerhans and to diabetes mellitus.
On the relation of chronic interstitial pancreatitis to the islands of Langerhans and to diabetes mellitus.
复制标题
DOI：
10.1084/jem.5.4.397
复制
发表时间：
1901-01-01
影响因子：
15.3
通讯作者：
Opie, EL
中科院分区：
文献类型：
--
作者：
Opie, EL
(1)先天性梅毒性胰腺炎可延缓腺泡的发育，但不影响朗格汉斯岛。后者嵌入间质中，但不受其侵入，与共同起源的小管和腺泡保持连续性。(2)影响发育胰腺的两种类型的慢性间质性炎症是可区分的：（a）小叶间胰腺炎。在小叶间型中，炎性过程主要位于小叶的外周，只有当硬化过程达到非常晚期时，才会累及朗格汉斯岛。当胰管阻塞后出现胰腺炎时，这些岛状突起虽然嵌在致密的瘢痕样组织中，但长期保持不变。(b)腺泡间胰腺炎在腺泡间型中，突起是弥漫性的，侵入小叶并分离单个腺泡。炎性变化侵入朗格汉斯岛。(3)已观察到朗格汉斯岛病变与糖尿病发生之间的关系。(a)11例小叶间胰腺炎中有1例发生轻度糖尿病。在这种情况下，硬化症是在结石阻塞导管之后发生的，已经严重发展并影响了朗格汉斯岛。(b)在2/3例腺泡间胰腺炎病例中，存在糖尿病。第三个病例与血色病有关，在后期与糖尿病有关，糖尿病是胰腺病变的结果。(c)在第四个糖尿病病例中，毛细血管和实质细胞之间的透明存款完全改变了朗格汉斯岛，以至于它们不再被识别。
(1) Congenital syphilitic pancreatitis retards the development of the glandular acini but does not affect the islands of Langerhans. Embedded in the stroma, but not invaded by it, the latter maintain their continuity with the small ducts and acini with which they have a common origin. (2) Two types of chronic interstitial inflammation affecting the developed pancreas are distinguishable: (a) Interlobular Pancreatitis.—In the interlobular variety the inflammatory process is localized chiefly at the periphery of the lobule and implicates the islands of Langerhans only when the sclerotic process has reached a very advanced grade. When pancreatitis has followed obstruction of the ducts, the islands long remain unaltered though embedded in dense scar-like tissue. (b) Interacinar Pancreatitis.—In the interacinar type the process is diffuse, invading the lobules and separating individual acini. The inflammatory change invades the islands of Langerhans. (3) A relationship has been observed between lesions of the islands of Langerhans and the occurrence of diabetes mellitus. (a) In one of eleven cases of interlobular panereatitis diabetes of mild intensity occurred. The sclerosis, which in this case followed obstruction of the ducts by calculi, was far advanced and affected the islands of Langerhans. (b) In two of three cases of interacinar pancreatitis, diabetes was present. The third case was associated with a condition, hæmochromatosis, which at a later stage is associated with diabetes, the result of pancreatic lesion. (c) In a fourth case of diabetes, hyaline deposit between the capillaries and the parenchymatous cells had so completely altered the islands of Langerhans that they were no longer recognizable.