PANCREAS I Flashcards
CONGENITAL ANOMALIES
_________ is the most common congenital anomaly of the pancreas
_________ is caused by a failure of fusion of the fetal duct systems of the dorsal and ventral pancreatic primordia
pancreatic divisum
CONGENITAL ANOMALIES
_________ is a band like ring of normal pancreatic tissue that completely encircles the 2nd portion of the duodenum
annular pancreas
CONGENITAL ANOMALIES
_________. pancreatic tissue that is aberrantly situated, or ectopic, is found in about 2% of careful routine postmortem examinations
ectopic pancreas
CONGENITAL ANOMALIES
_________. very rarely the pancreas fails to develop (____). Some cases of agenesis are caused by homozygous germline mutations involving PDX1, a gene encoding a homebox transcription factor that is critical for pancreatic development
agenesis
PANCREATITIS
divided into 2 forms ______ and ____. each with its own characteristic pathologic and clinical features
acute and chronic
PANCREATITIS
__________ is characterized by reversible pancreatic parenchymal injury and inflammation and has many causes including toxic exposures, pancreatic duct obstruction, inherited genetic defects, and infections
acute pancreatitis
ACUTE PANCREATITIS
_________ is most commonly caused by gallstones and billiary sludge but can also stem from periampullary neoplasms, choledochoceles, parasites and pancreas divisum
pancreatic duct obstruction
ACUTE PANCREATITIS
____________ leads to release of digestive enzymes, inflammation, and tissue autodigestion
primary acinar cell injury 1
ACUTE PANCREATITIS
_______________. in normal acinar cells, digestive enzymes and lysosomal hydrolases are transported via separate pathways.
defective intracellular transport
ACUTE PANCREATITIS
3 genes implicated in hereditary pancreatitis
P
S
C
PRSS1
SPINK1
CFTR
ACUTE PANCREATITIS MORPHOLOGY
in more limited forms of ________ histologic alterations are limited to mild inflammation, interstitial edema, and focal fat necrosis within the pancreas and the peripancreatic fat
in _______, acini, ducts, and even islets undergo necrosis.
in most severe form __________, extensive parenchymal necrosis is accompanied by intraparenchymal hemorrhage due to vascular injury.
acute interstitial pancreatitis
acute necrotizing pancreatitis
hemorrhagic pancreatitis
ACUTE PANCREATITIS CLINICAL FEATURES
__________ is the cardinal manifestation of acute pancreatitis
lab findings include elevation of serum ______ and _____ during the first 4-12 hours following the onset of pain
abdominal pain
amylase and lipase
PANCREATITIS
type of pancreatitis
_________ is defined as prolonged inflammation of the pancreas associated with irreversible destruction of exocrine parenchyma, fibrosis and in the late stages, loss of endocrine parenchyma
chronic pancreatitis
CHRONIC PANCREATITIS
___________ is associated with the presence of immunoglobulin G4 (IgG4)-secreting plasma cells in the pancreas and is one manifestation of a systemic IgG related disease
typically displays swirling or storiform fibrosis, obliterative inflammation of the veins (phlebitis), and a dense lymphoplasmacytic inflammation that is enriched in IgG4-secreting plasma cells
autoimmune pancreatitis type 1
CHRONIC PANCREATITIS
_________ is restricted to the pancreas with the exception of subset of patients with ulcerative colitis
autoimmune pancreatitis type 2
NONNEOPLASTIC CYSTS
________ are uniocular, thin walled cysts, that likely result from anomalous pancreatic duct development
associated with conditions such as autosomal dominant polycystic kidney disease, and von hippel lindau disease
congenital cysts
NONNEOPLASTIC CYSTS
________ are formed when areas of intrapancreatic or peripancreatic hemorrhagic fat necrosis are walled off by fibrosis and granulation tissue
pseudocysts
CYSTIC NEOPLASMS
__________- usually occur in the tail of the pancreas. the cysts are small (1-3 cm) and can be solitary, multiple, or present as a honeycomb of microcytic lesions.
close to 95% of __________ arise in woman and in contrast to serous cystic neoplasms they are precursors to invasive carcinomas, usually arises in the tail of the pancreas, and present as painless slow growing masses
____________ are mucin producing neoplasms that involve larger ducts of the pancreas
serous cystic neoplasms
mucinous cystic neoplasms
intraductal papillary mucinous neoplasms
CHRONIC PANCREATITIS
patients with hereditary pancreatitis associated with _________ mutations have a 40% lifetime risk of developing pancreatic cancer
PRSS1-mutations
PANCREATIC CARCINOMA
________- is the most frequently altered oncogene in pancreatic cancer, with activating point mutations present in greater than 90% of cases
KRAS (chromosome 12p)
PANCREATIC CARCINOMA
inactivation of _______, ________, and _______ tumor supressor
TP53, SMAD4, BRCA2
