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BLOCK E - DIGESTION > Essentials: Pancreas Pathology (Summary Slides) > Flashcards

Essentials: Pancreas Pathology (Summary Slides) Flashcards

1
Q

Pancreatitis (2 types)

A

Acute Pancreatitis
Chronic Pancreatitis

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2
Q

Pancreatitis (definition + cause)

A

Inflammation of the pancreas caused by autodigestion of the pancreas by its own enzymes, due early enzyme activation

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3
Q

Key difference between acute and chronic pancreatitis

A

Acute: REVERSIBLE
Chronic: IRREVERSIBLE

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4
Q

Key features of acute pancreatitis (4)

A
  • fat necrosis (saponification, calcium precipitation and hypocalcemia)
  • parenchymal necrosis
  • acute inflammation
  • hemorrhage
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5
Q

Key features of chronic pancreatitis (3)

A
  • Calcification
  • Gland dropout (atrophy)
  • Fibrosis
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6
Q

3 main causes of acute pancreatitis

A
  • Alcohol (#1)
  • Gallstones (#2)
  • Drugs, vascular, infectious, genetic
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7
Q

Genetic mutations that can cause acute pancreatitis (2)

A

Mutations in genes PRSS, SPINK1

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8
Q

Complications of acute pancreatitis (6)

A
  • DEATH (this is a medical emergency)
  • Disseminated intravascular coagulopathy (DIC)
  • Acute respiratory distress syndrome (ARDS)
  • Hypocalcemia
  • Peritonitis
  • Pseudocyst
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9
Q

4 main causes of chronic pancreatitis

A
  • Alcohol (#1)
  • Autoimmune (IgG4)
  • Genetic
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10
Q

3 genetic mutations that can cause chronic pancreatitis

A

Mutations in genes PRSS1, SPINK1
Cystic fibrosis

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11
Q

4 complications of chronic pancreatitis

A
  • Weight loss
  • malabsorption
  • diabetes mellitus
  • pancreatic cancer
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12
Q

Autoimmune pancreatitis responds well to…

A

steroids

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13
Q

2 types of non-neoplastic pancreatic cysts (i.e. no new growth, no malignant potential)

A

Congenital cysts
Pseudocysts

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14
Q

2 types of neoplastic pancreatic cysts without papillary structures

A

Serous cystadenoma
Mucinous cystic neoplasms

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15
Q

2 types of neoplastic pancreatic cysts WITH papillary structures

A

Intraductal papillary mucinous neoplasm (IPMN)
Solid pseudopapillary neoplasms

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16
Q

Congenital cystic lesions of the pancreas: important features

A

Benign
Developmental

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17
Q

Congenital cysts are associated with 2 diseases…

A

Polycystic kidney disease
Von Hippel-Lindau syndrome

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18
Q

Most common type of pancreatic cysts

A

Pseudocysts

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19
Q

What are pseudocysts (pancreas)?

A

Collections of necrotic material rich in pancreatic enzymes. They are not true cysts because they have no epithelial lining.

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20
Q

Why are pseudocysts not considered “real” cysts?

A

They do not have an epithelial lining

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21
Q

Pseudocysts of the pancreas usually develop secondary to…

A

pancreatitis

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22
Q

Serous cystadenoma (definition + key features)

A

Neoplastic cyst of the pancreas without papillary structures.
They have NO malignant potential (benign).

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23
Q

Key histological feature of serous cystadenoma

A

Multilocular (having many small compartments)

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24
Q

Serous cystadenomas usually affect…

25
Q

Serous cystadenomas may be associated with a syndrome called…

A

Von Hippel-Lindau syndrome

26
Q

Mucinous cystic neoplasms (definition + key features)

A

Neoplastic cysts of the pancreas without papillary structures.
They DO have malignant potential!

27
Q

How do we manage mucinous cystic neoplasms?

A

Since they have malignant potential, they need to be resected.

28
Q

Mucinous cystic neoplasms usually affect…

29
Q

Key hisotlogical features of mucinous cystic neoplasms

A

They are made up of mucus-secreting cells and ovarian-like stroma

29
Q

Mucinous cystic neoplasms have NO connection to…

A

the duct system

30
Q

Intraductal papillary mucinous neoplasm (IPMN) (definition + key features)

A

Neoplastic cysts of the pancreas with papillary structures.
They have malignant potential!!!

31
Q

How do we manage intraductal papillary mucinous neoplasms?

A

Since they have malignant potential, they need to be resected.

32
Q

Intraductal papillary mucinous neoplasms (IPMN) usually affect…

33
Q

Key histological feature of intraductal papillary mucinous neoplasms (IPMN)

A

Made of mucous cells

34
Q

What type of pancreatic cyst has NO connection to ducts? What type of cyst is intimately connected with ducts?

A

No connection to duct system: Mucinous cystic neoplasms

Connection to duct system: Intraductal papillary mucinous neoplasm (IPMN)

35
Q

Solid pseudopapillary neoplasm (definition + key features)

A

RARE neoplastic cyst of the pancreas with papillary structures. It has malignant potential (locally agressive).

36
Q

How do we manage solid pseudopapillary neoplasms?

A

Since they have malignant potential (locally aggressive), they must be resected.

37
Q

solid pseudopapillary neoplasms usually affect…

A

young females

38
Q

Name 4 types of pancreatic cancer

A
  1. Ductal adenocarcinoma
  2. Neuroendocrine tumours
  3. Acinar carcinoma
  4. Pancreatoblastoma
39
Q

Most (90%) of pancreatic cancers are…

A

ductal adenocarcinomas

40
Q

Ductal adenocarcinomas are a cancer of…
a) exocrine pancreas
b) endocrine pancreas

A

a) exocrine pancreas

41
Q

Ductal adenocarcinoma usually affects…

42
Q

Key histological features of ductal adenocarcinomas (3)

A
  • Haphazard glands
  • Desmoplastic stroma (fibrosis)
  • Perineural invasion (common)
43
Q

Ductal adenocarcinoma is characterized by elevated serum markers…

A

CEA ad CA19.9

44
Q

Precursor of ductal adenocarcinoma

A

Pancreatic intraepithelial neoplasia (PanIN)

45
Q

Gene mutations that cause ductal adenocarcinomas (4)

A

Mutations in genes KRAS, TP53, SMAD4, BRCA2

46
Q

Ductal adenocarcinoma risk factors (8)

A
  • Chronic pancreatitis
  • Smoking
  • Hereditary pancreatitis (PRSS1, SPINK1)
  • BRAC1 and BRCA2 genes
  • Lynch syndrome (mismatch repair proteins are dysfunctional)
  • FAP syndrome (APC gene)
  • Peutz-Jeghers syndrome
  • Familial melanoma syndrome
47
Q

Which part of the pancreas does ductal adenocarcinoma usually present in?

A

Head of pancreas

48
Q

Presentation of ductal adenocarcinoma at the head of pancreas vs body/tail

A

Head: Presents with jaundice & pruritus (itching)
Body/Tail: Pain, weight loss

49
Q

Ductal adenocarcinomas are a cancer of…
a) exocrine pancreas
b) endocrine pancreas

A

b) endocrine pancreas

50
Q

What cells of the pancreas are affected by neuroendocrine tumours?

A

Islet cells

51
Q

Functional vs non-functional neuroendocrine pancreatic tumours

A

Functional: Mostly benign
Non-functional: Mostly malignant

52
Q

What 3 criteria do neuroendocrine (non-functional) tumours have to meet to be considered malignant?

A
  • Vascular invasion
  • Local invasion
  • Metastasis (lymph nodes, liver, distant)
53
Q

4 types functional neuroendocrine pancreatic tumours

A
  • insulinoma
  • gastrinoma
  • glucagonoma
  • somatostatinoma
54
Q

Most FUNCTIONAL neuroendocrine tumours of the pancreas are…

A

insulinomas

55
Q

Insulinomas cause…

A

hypoglycemia

56
Q

Neuroendocrine tumours of the pancreas are associated with a genetic disorder called…

A

MEN1 syndrome

57
Q

Name 2 rare pancreatic cancer subtypes

A

Acinar carcinoma
Pancreatoblastoma (pediatric tumour)

58
Q

Name a a rare pancreatic cancer/tumour affecting children

A

Pancreatoblastoma (pediatric)

BLOCK E - DIGESTION (30 decks)

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