Pancreas GB Path- Nelson Flashcards
Pancreatic agenesis
Absence of the pancreas
Usually has other malformation- incompatible with life
Pancreatic divisum
Failure of fusion of the fetal dorsal and ventral pancreatic ducts
Annular pancreas
Band-like ring of normal pancreatic tissue that completely encircles the second portion of the duodenum
Ectopic pancreas
Ectopic pancreatic tissue can be found in the stomach, duodenum, jejunum, meckel’s diverticulum and ileum
How are fatty tissue and pancreatic parenchyma injured in acute pancreatitis?
Autodigestion by premature activation of pancreatic enzymes
How does chronic pancreatitis lead to pancreatic insufficiency?
-repeated acinar cell injury
-production of fibrogenic cytokines (TGF-beta and PDGF)
-Myofibroblast proliferation
-Collagen secretion
-Remodeling/fibrosis
=Pancreatic insufficeincy
Key microscopic finding in acute pancreatitis?
Fat necrosis and focal pancreatic parenchymal necrosis
What do you treat type I autoimmune pancreatitis?
Glucocorticoid
What are the gross and microscopic findings of type I autoimmune pancreatitis?
Gross= white fibrotic mass Micro = periductal lymphoplasmacytic inflammation
What is IgG4 related disease?
Fibroinflammatory condition characterized by tumerfactive lesions, dense lymphoplasymacytic infiltrate rich in IgG4 positive plasma cells
Serous Cystadenoma
Benign cystic neopalsm of pancreas
GLycogen rich CUBOIDAL CELLS filled with clear, straw colored fluid
Mucinous Cystadenoma
Benign or malignant neoplasm of pancreas
COLUMNAR mucinous epithelium and a dense “ovarian” stroma is present
Intraductaual papillary mucinous
Benign or malignant neoplasm of pancreas
Dilated duct system
Most have intestinal-type papillae (resemble papillae of villous adenomas of the large bowel)
Two most common risk factor for pancreatic exocrine carcinoma?
Smoking
Chronic pancreatitis
Painful (abdominal, epigastric back)
Jaundice
Weight Loss
Pancreatic Exocrine Carcinoma
How is pancreatic carcinoma diagnosed?
Mass lesion on CT
Tissue biopsy endoscopic ultrasound guided fine needle aspiration
What is the whipple procedure?
En bloc removal of the head and neck of pancreas, proximal duodenum, and gallbladder
Main differences between pancreatic exocrine and neuroendocrine tumors?
Exocrine:
- ill-defined in the HEAD of pancreas
- Presents with pain, jaundice, weight loss
- Short clinical course
Neuroendocrine:
- Well-circumscribed in the BODY or TAIL of pancreas
- Prolonged clinical course
Phrygian cap?
Normal anatomical variant
Fold in gallbaldder where the fundus joins the body
3 general things that can cause gallstones?
- Increased cholesterol/bilirubin
- Decreased biles Acids
- Stasis (think progesterone during pregnancy!)
What are pigment gallstones?
Bilirubin + calcium salts
What do you use to visualize gallstones with?
Ultrasound!
What choledocholithiasis?
Stones in the COMMON bile duct
What is cholecystitis? What normally causes it?
Acute or chronic inflammation of gallbladder
Most common blocking cystic duct
