Pancreas Flashcards
what is the hooked portion of the pancreas called and why is it important
uncinate process - important because it becomes a surgical margin
where is the pancreas located
retroperitoneal
does the pancreas have a capsule
no
define endocrine
substances are secreted directly into bloodstream
define exocrine
substances are secreted into a ductal system
what is the endocrine portion (1-2%) of the pancreas
islets of langerhans which include beta cells, alpha cells, delta cells, and PP cells
what is the exocrine portion of the pancreas composed of
acinar cells and ducts
what are acinar cells made of
zymogen granules
what do zymogen granules of acinar cells do
make digestive, pancreatic enzymes
what do the small pancreatic ducts release
bicarbonate fluid
what do the large pancreatic ducts release
mucin
what do the pancreatic ducts express
cystic fibrosis transmembrane conductance regulator (CFTR)
what is the most common congenital anomaly of the pancreas
pancreas divisum
what is pancreas divisum
congenital anomaly where the duct of wirsung does not connect to the duct of Santorini
most patients are asymptomatic but it can cause pancreatitis
what is annular pancreas
congenital anomaly where there is a band-like ring of pancreatic tissue that encircles the second portion of the duodenum
can lead to a duodenal obstruction
what is pancreatic heterotropia
congenital anomaly where there is pancreatic tissue in other areas of the abdominal cavity
ex. stomach
what is a pancreatic cyst
small, unilocular cyst made of a single layer of flattened cuboidal cells in a pancreatic duct
usually contains clear, serous fluid
what is an important fact about a pancreatic cyst
it does not communicate with the ductal system
what are the two conditions associated with pancreatic cysts
polycystic kidney disease
von Hippel-Lindau Syndrome
what three things will you see macroscopically in the pancreas of someone with cystic fibrosis
fibrosis
fat replacement
cyst formation
what will you see microscopically in the pancreas of someone with cystic fibrosis
dilation of acini with accumulation of eosinophilic secretions
what is hereditary hemochromatosis
recessive disease that is classified as the inappropriate increased iron absorption from the duodenum and small intestine
leads to a brown appearing pancreas macroscopically
what is the most common cause of acute pancreatitis
impaction of stones within the common bile duct (choledocholithiasis)
what is the second most common cause of acute pancreatitis
excessive alcohol intake
what is the macroscopic presentation of acute pancreatitis
fat necrosis
where is the most common location for adenocarcinoma of the pancreas
head
which two viruses can cause acute pancreatitis
mumps
coxsackievirus
which procedure can cause acute pancreatitis
endoscopy procedures like ERCP
what is fat saponification
fatty acids combine with calcium to form calcium soaps
what is the most common cause of chronic pancreatitis
long term alcohol abuse in middle aged men
what is the macroscopic presentation of chronic pancreatitis
parenchymal fibrosis with proteinaceous plugs
what are three ways in which alcohol affects the pancreas
increases contraction of sphincter of Oddi
causes protein plugs
generate free radicals in the acini
what is a pancreatic pseudocyst
the bodies attempt to wall off areas of necrotic pancreatic tissue
leads to a cystic structure made of fibrosis
the cyst is often filled with pancreatic enzymes
what is autoimmune pancreatitis
form of chronic pancreatitis that is a IgG4 related disease
leads to sclerosing cholangitis (inflammation of the bile duct)
onion-skin is seen in which condition
primary sclerosing cholangitis
what are the three types of non-cystic exocrine pancreatic neoplasms
pancreatic intraepithelial neoplasia
ductal adenocarcinoma
acinar cell carcinoma
what are the three types of cystic exocrine pancreatic neoplasms
serous cystic
mucinous cystic
intraductal papillairy
what is a pancreatic intraepithelial neoplasia (PanIN)
precursor, “in-situ” lesion of pancreatic ductal adenocarcinoma
classified by WHO in PanIN-1-3
which cancer has one of the highest mortality rates of all malignancies
ductal adenocarcinoma
85-90% of all pancreatic neoplasms are what
ductal adenocarcinoma
what are some risk factors to ductal adenocarcinoma
old age
smoking
chronic pancreatitis
diabetes mellitus
genetic defects
what is the most frequent altered oncogene in pancreatic cancer
KRAS
what is the most frequently inactivated tumor suppressor gene
P16
what is acinar cell carcinoma
lobulated, encapsulated mass with a flesh consistency
what are the two categories of WHO classifications for serous cystic neoplasms
serous cystadenoma (benign)
serous cystadenocarcinoma (malignant)
what is a microcystic serous cystadenoma
benign cyst that is very sponge/honeycomb like
made of many smaller cysts filled with small watery fluid
has a central, fibrous scar
what is a macrocystic serous cystadenoma
benign, unilocular cyst that only has one layer of cuboidal cells
what are the two types of mucin producing cystic neoplasms
mucinous cystic neoplasm (MCN)
intraductal papillary mucinous neoplasm (IPMN)
who is most likely to get a mucinous cystic neoplasia
women around 50 years of age
what is the difference between a mucinous cystic neoplasm and a intraductal papillary mucinous neoplasm
the mucinous cystic neoplasm has no communication with the ductal system
the intraductal papillary mucinous neoplasm communicates with the ductal system
what is the most important diagnostic feature of a mucinous cystic neoplasm
ovarian-type stroma beneath the epithelium
what is the most common neoplastic cyst of the pancreas
intraductal papillary neoplasia
what is the microscopic presentation of a intraductal papillary neoplasm
papillary architecture with mucin producing cells
what is the most common type of pancreatic neuroendocrine tumor
insulinoma
what is the most common pancreatic neoplasm in young children
pancreatoblastoma
pancreatoblastomas are associated with which condition
beckwith-weidemann syndrome
what could you see under the microscope in the pancreas of a patient with diabetes mellitus
amyloid deposits
