Pancreas histology Flashcards

1
Q

acute pancreatitis causes

A

duct obstruction (gall stones 50%), metabolic (alcohol 33%), drugs, hypercalcaemia, hyperlipidaemia, poor blood supply, infection, autoimmune 15%

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2
Q

Ductal carcinoma

A

arise from dysplastic ductal lesions: pancreatic intraductal neoplasia (PanIn), intraductal mucinous papilliary neoplasm (IMPN)

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3
Q

DUCTAL CARCINOMA PATHOLOGY

A

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)

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4
Q

what is desmoplastic stroma

A

fibrous response to cancer

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5
Q

ductal carcinoma sites

A

head 60%, body tail, diffuse

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6
Q

cystic tumours

A

contain serous or mucin secreting epithelial (corresponding tumours arise in the ovary), usually benign

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7
Q

pancreatic endocrine neoplasm marker

A

chromogranin

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8
Q

pancreatic endocrine neoplasm is associated with what syndrome

A

MEN1

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9
Q

what is the commonest secretory tumour

A

insulinomas

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10
Q

gall stones risk factors

A

female, native americam, disorder of bile mtabolism, oral contraceptive, rapid weight loss

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11
Q

gall stone types

A

cholesterol (more than 50%), may be signle mostly radiolucent,

pigment (contain calcium salts of unconjugated bilirubin,) multiple, mostly radioopaque,

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12
Q

what is acute pancreatitis

A

Acute inflammation of the pancreas caused by aberrant release of
pancreatic enzymes

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13
Q

how does duct obstruction cause pancreatitis

A

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

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14
Q

how does alcohol cause pancreatitis

A

Alcohol leads to spasm/oedema of Sphincter of Oddi
and the formation of a protein rich pancreatic fluid
which obstructs the pancreatic ducts

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15
Q

acute pancreatitis pattern of injury

A

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

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16
Q

acute pancreatitis prognosis/complications

A

ancreatic : pseudocyst, abscess
Systemic: shock, hypoglycaemia, hypocalcaemia
Overall mortality up to 50% for haemorrhagic
pancreatitis

17
Q

causes of chronic pancreatitis

A
Metabolic/toxic Alcohol (80%)
Haemochromatosis
Duct obstruction Gallstones
Abnormal pancreatic duct anatomy
Cystic fibrosis (“mucoviscoidosis”)
Tumours
Idiopathic Autoimmune
18
Q

chronic pancreatitis pathogenesis

A

• Pathogenesis of chronic pancreatitis
As for acute pancreatitis
• Pattern of injury
Chronic inflammation with parenchymal fibrosis and loss of
parenchyma
Duct strictures with calcified stones with secondary dilatations

19
Q

pancreatic pseudocyst

A

Associated with acute and/ or chronic pancreatitis
• Lined by fibrous tissue (no epithelial lining), contain
fluid rich in pancreatic enzymes or necrotic material
•Connect with pancreatic ducts
•May resolve, compress adjacent structures, become
infected or perforat

20
Q

what is autoimmune pancreatitis

A

Characterised by large numbers of IgG4 positive plasma
cells.
• May involve the pancreas, bile ducts and almost any other
part of the body.

21
Q

most common tumour of the pancreas

A

ductal (85%)

22
Q

pancreatic tumour types

A
Carcinomas
Ductal (85% of all neoplasms)
Acinar 
• Cystic neoplasms
Serous cystadenoma
Mucinous cystic neoplasm
• Pancreatic neuroendocrine tumours (
23
Q

ductal carcinoma complication

A

Due to spread
•Chronic pancreatitis
•Venous thrombosis (“migratory thrombophlebitis”)

24
Q

chronic cholecystitis

A

Chronic inflammation
• Fibrosis
•Diverticula – Rokitansky-Aschoff sinuses
• 90% contain gall stones