Pancreas Flashcards

1
Q

Benign mimics of malignancy

A

chronic pancreatitis

squamous metaplasia

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2
Q

Causes of pancreatitis

A

GET SMASHED

gallstones

ethanol

trauma

steroids

mumps

autoimmune

scorpion venom

hyperlipidaemia

ERCP

drugs

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3
Q

Autoimmune pancreatitis - types and features

A

Type 1 (IgG4 related):

Obliterate phlebitis

storiform sclerosis

duct centred lymphoplasmacytosis

>50 IgG4 plasma cell/HPF

>40 IgG4:IgG plasma cells

Type 2 (idiopathic duct centred pancreatitis)

Duct centred lymphoplasmacytosis

granulocytic epithelial lesions (intraepithelial neutrophilic microabscesses)

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4
Q

Cystic lesions

A

Pseudocyst

hydatid cyst

duct ectasia in chronic pancreatitis

LE cyst

dermoid cyst

serous cystadenoma

mucinous cystic neoplasm

intraductal papillary mucinous neoplasm

solid pseudopapillary neoplasm

cystic malignancy (incl mets)

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5
Q

Ductal adenoca vs chronic pancreatitis

A

CP:

lobular

Ducts open and with smooth contours

protein plugs

islets preserved

+/- pseudocysts

minimal atypia, no mitoses

Adenoca:

irregular +/- single cells

tufting, micropapillary, cribriform patterns

ruptured ducts

desmoplasia

extrapancreatic infiltration (diagnostic if in fat)

PNI and LVI

large cells (3x lymph), variation 4:1

Loss of SMAD4

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6
Q

Acinar cell ca vs PanNET vs SPN

A

ACC: palisaded stromal nuclei, red nucleoli, granular eosinophilic cytoplasm, trypsin/chymotrypsin+

NET: S&P chromatin, no nucleoli, trypsin-

SPN: young females, grooved uniform nuclei, PR and beta catenin+

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7
Q
A

Nesidiodysplasia (islet cell hyperplasia, esp post gastric bypass)

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8
Q

NET grading

A

G1: ki67<3% and mitoses <2/10hpf

G2: ki67 3-20% or mitoses 2-20/10hpf

G3 (NEC): ki67 >20% and mitoses >20/10hpf

(minimum 500 cells for ki67, 50hpf for mitoses)

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9
Q
A

Pancreatoblastoma (squamous corpuscles are pathognomonic)

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10
Q

Preinvasive ductal lesions

A

PanIN: 1a, 1b, 2, 3

intraductal papillary mucinous neoplasm

intraductal tubulopapillary neoplasm (IPMN with tubules and without mucin)

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