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Pathology > Chapter 19- The Pancreas > Flashcards

Chapter 19- The Pancreas Flashcards

1
Q

What are the two components of the pancreas and what cells are the made up of?

A
  1. Exocrine- acinar cells

2. Endocrine- islets of Langerhans

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2
Q

What congenital anomalies can affect the pancreas?

A

Pancreas divisum- failure of duct system fusion

Annular pancreas- ring of normal pancreas encircling the duodenum (ventral buds split)

Ectopic pancreas

Agenesis

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3
Q

What is the most common pancreatic congenital anomaly?

A

Pancreas divisum

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4
Q

Where are ectopic pancreases most commonly found?

A

Stomach > duodenum > jejunum

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5
Q

What is the cause of pancreatitis?

A

Autodigestion by pancreatic enzymes

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6
Q

What are the two primary causes of acute pancreatitis?

A

Biliary tract disease (obstruction- gallstones)

Alcoholism

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7
Q

What is the pathology of acute pancreatitis?

A

Inappropriate release and activation of enzymes

Inflammation and thrombosis damage acinar cells and increase enzyme activation (enzymes are released when cells are damaged)

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8
Q

How does alcoholism cause pancreatitis?

A

CYTP450 receptors are found on the ducts epithelium

Targeted by acetaldehyde

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9
Q

What are the effects of acute pancreatitis?

A

Edema

Inflammation

Fat necrosis

Proteolysis

Hemorrhage

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10
Q

What differentiates chronic and acute pancreatitis?

A

Chronic- irreversible parenchymal destruction and fibrosis

Acute- damage is reversible

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11
Q

What can cause chronic pancreatitis?

A

Repeated bouts of acute pancreatitis

Long term alcohol abuse

Long standing obstruction

Autoimmune disorder

Hereditary syndromes

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12
Q

What is the morphology of chronic pancreatitis?

A

Dense, fibrous tissue

Islets spared until late stages

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13
Q

What can chronic pancreatitis lead to?

A

Malabsorption

Diabetes mellitus

Psuedocysts

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14
Q

What are the two forms of nonneoplastic pancreatic cysts?

A
  1. Congenital

2. Psuedocysts

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15
Q

What is the morphology of pancreatic congenital cysts?

A

Unilocular, thin walled with cuboidal epithelium

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16
Q

What causes congenital cysts in the pancreas?

A

Abnormal pancreatic duct development

Polycystic kidney disease

Von Hippel-Lindau disease

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17
Q

What are pancreatic pseudocysts?

A

Cystic collections of necrotic, hemorrhagic material

No epithelium

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18
Q

What is the most common form of pancreatic cysts?

A

Pseudocysts

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19
Q

What types of pancreatitis can develop psuedocysts?

A

Acute and chronic

20
Q

What are the different forms of pancreatic cystic neoplasms and where are they located?

A
  1. Serous- pancreatic tail
  2. Mucinous- pancreatic rail
  3. Intraductal papillary mucinous neoplasms (IPMNs)- head of pancreas
  4. Solid pseudopapillary tumour
21
Q

What is the characteristic architecture of serous pancreatic cysts?

A

Microcystic/spongey

22
Q

What kind of fluid is in serous pancreatic cysts?

A

Watery/transparent

23
Q

Are serous cysts more often benign or malignant?

A

Benign

24
Q

What epithelial type is present in serous pancreatic cysts?

A

Cuboidal

25
Q

What is the morphology of mucinous pancreatic cysts?

A

Multiloculated

Mucin-producing columnar cells

Multicystic cut surface

26
Q

One third of mucinous pancreatic cysts harbour what form of cancer?

A

Invasive adenocarcinoma

27
Q

What is the morphology of IPMNs?

A

Dilated ducts with papillae

28
Q

What can IPMNs progress to?

A

Invasive cancer

29
Q

What is the morphology of solid pseudopapillary tumours of the pancreas?

A

Round, well circumscribed with solid and cystic areas

Large size

30
Q

What is curative for solid pseudopapillary tumours?

A

Complete resection

31
Q

What precursor lesion is believed to cause pancreatic carcinoma?

A

Pancreatic intraepithelial neoplasia (PanIN)

32
Q

What is PanIN?

A

Well defined, no invasive lesion of the pancreatic ducts

33
Q

What is a Whipple procedure?

A

Removal of the head of the pancreas and part of the duodenum

34
Q

Where are the majority of pancreatic carcinomas found?

A

Head > diffuse > body > tail

35
Q

What kind of response do pancreatic carcinomas elicit?

A

Strong desmoplastic response (intense surrounding fibrosis)

36
Q

How can cancers in the head of the pancreas cause jaundice?

A

Obstruct duct

37
Q

Pancreatic cancers in what location can remain clinically silent?

A

Body and tail

38
Q

What syndrome can occur in pancreatic carcinoma?

A

Trousseau

40
Q

Where do the majority of acinar cell carcinomas occur?

A

Head > tail > body

41
Q

What is the morphology of acinar cell carcinoma?

A

Solid, fleshy, circumscribed

42
Q

What type of component is found in 40% of acinar cell carcinomas?

A

Endocrine

43
Q

Pancreatoblastoma is found in what type of patient?

A

Children

44
Q

What is the morphology of pancreatoblastoma?

A

Squamous islands, mixed with acinar cells

45
Q

How do insulin producing tumours and other neuroendocrine tumours of the pancreas differ?

A

Insulin producing- 90% benign

Other- 60-90% malignant

46
Q

What is the most common neuroendocrine tumour of the pancreas?

A

Insulin producing

47
Q

What is the morphology of pancreatic endocrine tumours?

A

Less than 2cm

Encapsulated/sharply circumscribed

Pale-red/brown

Pathology (25 decks)

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