Histopathology - Pancreas

Question 1

Answer 1

Liponecrosis Pancreatis

 Form of coagulative necrosis

 Necrosis is not related to blood supply, but rather, enzymes: lipase is activated and acts on

triglycerides. Ca2+ and fatty acids undergo saponification.

o Hypocalcemia leads to tetany

 Note the eosinophilic spots where structure of cells has disappeared

 Saponified fat of the necrotic adipocytes (anucleated) stains eosinophilic because it is not

removed in tissue processing as normal fat.

 Acute inflammatory cells are seen in the border between viable and necrotic tissue

 Pancreatitis caused by gall stones, alcohol, infection, injury

Question 2

Answer 2

Chronic pancreatitis

 Islets of Langerhans seen, but exocrine acinar part is missing

 Results in malabsorption

 Secretory ducts are seen

 Acute pancreatitis would show fat necrosis

 Causes

 CF due to mucus plugs

 Autoimmune
 Alcohol (most common)

Question 3

Answer 3

Pancreatic Carcinoma

 Ductal carcinoma is the most common and most lethal form

 Islets, scar tissue with chronic pancreatitis, dysplastic ducts

 Peripheral nerve cross-section with cells in capsule. Perineural spreading is typical of pancreatic carcinoma

 This causes the symptom of back pain

 Ducts with increased basophilia