Histopathology 7 - Diseases of the pancreas and gall bladder Flashcards
Recall the mnemonic for the causes of acute pancreatitis
I GET SMASHED
Idiopathic
Gallstones
Ethanol
Trauma
Steroids Mumps Autoimmune Scorpion sting Hyperlipidaemia/hypercalcaemia/hyperparathyroidism ERCP Drugs
Recall two causes of pancreatitis via duct obstruction
Gallstones Alcohol (via spasm/ oedema of Sphinter of Oddi)
Recall the pathophysiology of injury seen in acute pancreatitis
- Enzymes activated
- Acinar necrosis
- Enzyme release
Can cause anything from stromal oedema to haemorrhagic necrosis
Why are yellow/white foci seen in acute pancreatitis?
Lipases cause fat necrosis
Calcium ions bind to free fatty acids forming soaps (which are white yellow)
What is a pseudocyst?
Dilated space with no epithelial lining
What is a cyst?
Dilated space lined by epithelium
Recall 2 pancreatic and 3 systemic complications of acute pancreatitis
Pancreatic: pseudocyst + abscess
Systemic: shock, hypoglycaemia, hypocalcaemia
Recall 4 complications of chronic pancreatitis
Malabsorption
Diabetes mellitus
Pseudocysts
Carcinoma of the pancreas
What is contained within a pancreatic pseudocyst?
Pancreatic enzymes and necrotic material (which is why it’s so bad when they perforate - it causes peritonitis)
Which immunoglobin is implicated in autoimmune acute pancreatitis?
IgG4
What type of cancer makes up 85% of pancreatic neoplasms?
Ductal carcinoma
What mutation is very common in ductal carcinoma?
K-Ras
What are the 2 types of precancerous dysplastic ductal lesions in the pancreas?
- PanIn (pancreatic intraductal neoplasm)
2. Intraductal mucinous papillary neoplasm
Which type of tumour has a “gritty and grey” macroscopic appearance?
Ductal carcinoma
Define adenocarcinoma
Mucin-secreting glands set in desmoplastic stroma (means: strong stromal reaction)