Histopathology and immunohistochemistry of pancreatic islets in fibrocalculous pancreatic diabetes

The histopathology of Fibrocalculous Pancreatic Diabetes (FCPD) has been ex tensively studied, but there are no reports on alteration in patterns of ho rmone secreting cells using immunohistochemistry in islets of FCPD patients . In this study, we report on the histopathology and immunohistochemistry o f islets of FCPD patients and its possible correlation with the clinical pi cture. Pancreatic biopsies were carried out in six patients with FCPD at th e time of surgery for abdominal pain. Routine histopathology and immunohist ochemistry studies were carried out with six primary antibodies namely insu lin, glucagon, pancreatic polypeptide (PP), somatostatin, vasoactive intest inal peptide and gastrin. Histopathology of the pancreas showed a spectrum of changes ranging from moderate to severe atrophy, fibrosis of the parench yma and degeneration of the ducts. Nesidioblastosis was present in three pa tients. Immunohistochemical studies showed a decrease in the number of isle ts but some patients showed evidence of hyperplasia. There was an overall d ecrease in the percent of insulin cells and the positivity in the islets co rrelated with plasma C-peptide levels and the duration of diabetes. There w as no consistent relationship with glucagon with some patients showing incr eased and other decreased positivity. There was a marked decrease in PP and somatostatin positivity, the significance of which is not clear. The reduc tion, but partial preservation of insulin positivity is consistent with the ketosis resistance shown by patients with Fibrocalculous Pancreatic Diabet es. (C) 2001 Elsevier Science Ireland Ltd. AII rights reserved.