Pancreas histology Flashcards
acute pancreatitis causes
duct obstruction (gall stones 50%), metabolic (alcohol 33%), drugs, hypercalcaemia, hyperlipidaemia, poor blood supply, infection, autoimmune 15%
Ductal carcinoma
arise from dysplastic ductal lesions: pancreatic intraductal neoplasia (PanIn), intraductal mucinous papilliary neoplasm (IMPN)
DUCTAL CARCINOMA PATHOLOGY
macroscopic, gritty and grey, invade adjacent structure, tumours in head present earlier as it blocks ducts causes jaundice, adenomarcinomas on microscopic appearance, mucin secreting set in desmoplastic stroma (fibrous reaction to tumour)
what is desmoplastic stroma
fibrous response to cancer
ductal carcinoma sites
head 60%, body tail, diffuse
cystic tumours
contain serous or mucin secreting epithelial (corresponding tumours arise in the ovary), usually benign
pancreatic endocrine neoplasm marker
chromogranin
pancreatic endocrine neoplasm is associated with what syndrome
MEN1
what is the commonest secretory tumour
insulinomas
gall stones risk factors
female, native americam, disorder of bile mtabolism, oral contraceptive, rapid weight loss
gall stone types
cholesterol (more than 50%), may be signle mostly radiolucent,
pigment (contain calcium salts of unconjugated bilirubin,) multiple, mostly radioopaque,
what is acute pancreatitis
Acute inflammation of the pancreas caused by aberrant release of
pancreatic enzymes
how does duct obstruction cause pancreatitis
Gallstone stuck distal to where the common bile duct
and pancreatic ducts join leads to:
reflux of bile up the pancreatic duct followed by
damage to acini and release of proenzymes which
then become activate
how does alcohol cause pancreatitis
Alcohol leads to spasm/oedema of Sphincter of Oddi
and the formation of a protein rich pancreatic fluid
which obstructs the pancreatic ducts
acute pancreatitis pattern of injury
Periductal - necrosis of acinar cells near ducts (usually
secondary to obstruction)
Perilobular – necrosis at the edges of the lobules (usually due
to poor blood supply)
Panlobular – develops from 1. and 2