Diseases of the Exocrine Pancreas Flashcards
what do acinar cells do?
synthesize and secrete catalytic digestive enzymes
what are pacinian corpuscles?
normal pancreatic structures
mechanoreceptors related to sympathetic nerve endings in feline pancreas
what is acinar degeneration and atrophy due to?
local/systemic diseases: starvation, ductal obstruction, fibrosis
what is the most common cause of exocrine pancreatic insufficiency in dogs?
canine juvenile pancreatic atrophy
what clinical signs are associated with canine juvenile pancreatic atrophy?
diarrhea
steatorrhea
weight loss with voracious appetite
poor hair coat
when 90% of secretory capacity is lost
what is seen in the early stages of canine juvenile pancreatic atrophy (histology)?
intense T cell infiltration
what is acute canine pancreatitis like?
primarily necrotizing with reactive inflammation
what is chronic pancreatitis like?
primarily mononuclear
what is acute pancreatitis like in cats?
acute suppurative pancreatitis secondary to ascending bacterial infection
what is the pathogenesis of acute necrotizing pancreatitis?
inappropriate enzymatic activation/release and tissue autodigestion
what is the disease progression of acute necrotizing pancreatitis?
necrosis and saponification of peripancreatic mesenteric fat
necrosis of marginal acini
necrosis and reactive inflammation at periphery of affected lobules
what are the systemic consequences of acute necrotizing pancreatitis (release of proinflammatory mediators)?
acute hepatitis/hepatic necrosis
peritonitis
widespread vasculitis/thrombosis
hemorrhage
hypovolemic shock
DIC
what are the outcomes of acute necrotizing pancreatitis?
uncomplicated resolution
healing by fibrosis
abscessation
chronic, unresolved inflammation
bystander destruction of islets
what is the pathogenesis of chronic lymphocytic pancreatitis?
recurrent or unresolved bouts of pancreatic necrosis often with ductal obstruction
fibrosis, lymphoplasmacytic inflammation, atrophy
what flukes inhabit pancreatic ducts?
Eurytrema
Dicrocoelium
what are some proliferative lesion of the exocrine pancreas?
nodular acinar hyperplasia
adenoma
(adeno)carcinoma
what does nodular acinar hyperplasia look like?
multiple, variably-ssized discrete nodules throughout parenchyma
non-encapsulated, no compression of surrounding parenchyma
does nodular acinar hyperplasia cause compression of surrounding parenchyma?
no
what are the two neoplasms of the exocrine pancreas?
adenoma
(adeno)carcinoma
does an adenoma compress adjacent parenchyma?
yes
is an (adeno)carcinoma usually solitary and discrete or multiple?
solitary, discrete, circumscribed mass usually
what do islet cell tumors do?
functional: produce/secrete multiple hormones
what is the most common neoplasm of the endocrine pancreas that is identified?
insulinoma
what is paraneoplastic alopecia like?
symmetric ventral smooth, shiny skin in felines with pancreatic carcinoma
when might you see neuroglycopenia?
inculinoma
what is autolysis?
rapid postmortem release of digestive enzymes
what can acinar degeneration and atrophy be due to?
starvation
ductal obstruction
fibrosis
what are the causes of exocrine pancreatic insufficiency?
canine juvenile pancreatic atrophy
pancreatitis
necrosis
toxic injury
infection
ductal disease
neoplasia
what is exocrine pancreatic insufficiency?
congenital/acquired depletion of acinar tissue
what is triaditis?
IBD
suppurative cholangitis
suppurative pancreatitis
what happens with trypsinogen in acute necrotizing pancreatitis?
activated by premature intracellular fusion of lysosomes with zymogen granules
what is important in the inciting causes of acute necrotizing pancreatitis?
hypoperfusion/reperfusion
what is the importance of chronic lymphocytic pancreatitis?
usually incidental
if clinical: anorexia, vomiting, weight loss
what is superficial necrolytic dermatitis related to?
glucagonoma
