pancreas pathology Flashcards
Acute pancreatitis
generally related to biliary tract disease and or alcoholism
20% of patients will exhibit normal pancreas characteristics
40-60% will also have gallstones
CT better modality to evaluate moderate to severe cases
Chronic pancreatitis
continous flareups of mile of subclinical acute pancreatitis results in progressive destruction of pancreas
hyperlipidemia and hypercalcemia are predisposing factors
seen more often in alcoholics
more men that women
appears more echogenic and contour is irregular
calicificatoins may be seen
hemorrhagic pancreatitis
sudden escapr of ative lytic pancratic enzymes into the glandular parenchyma and destruction of the pancreatic tissue
abd pain, n/v, hypotension, metabolic acidosis and adult respiratory distress can be seen
phlegmonous pancreatitis
a spreading diffuse inflammatory edema of the subcutaneous connective tissue which may lead to necrosis
a phlegmon appears as a hypoechoic with good through transmission
\usually involves the lesser sac, pararenal space and transverse mesocolon
cystic masses of the pancreas
pseudocyst-most common
autosomal-dominat polycystic disease
Von Hippel-Lindau Sydrome
congential cystic leasions of the pancreas
cystic fibrosis
fibrocystic disease
solitary pancratic cysts
true systs
lymphoepithelial cysts
pseudocyst
complication of acute pancreatitis, may also occue due to trauma
dilitation resembling a cyst, contains fluid collections of inflammatory products, serour or hemorrhage
does not have a true wall
may have multiple septations and debris may have daughter cysts
pseudocyst locatoin
most common location is the lesser sac anterior to the pancreas and posterior to the stomach
second most common location is the anterior pararenal space
spontaneous rupture is the most common complication approx 5% of patients
clinical symptoms are sudden shock and peritonitis, mortality 50%
von hippel-lindau syndrome
rare, autosomal dominant disorder
characterized by central nervous system hemangioblastoma, retinal angiomas, renal cell carcinomas, pheochromocytomas and visceral cysts
tumors range in size 1-20 cm
liver metastases should also be ruled out
cystic fibrosis
disease of adolescents and young adults
complications occur due to the increased secretions of abnormal mucous by the exocrine glands
generally the pancreas is more echogenic with and uneven echo texture, can have cysts of varying size
abcess
developes as a result of extreme infection of the necrotic pancreatic and retroperitoneal tissues
classic signs: fever, chills, hypotension, tender abd, leukocytosis, bacteremia
can have simialar appearance of a pseudocyst
tumors
cystic neoplasm
adenocarcinoma
cystic neoplasm
rare
microcystic benign
macrocyst (.2cm) with solid components usually malignant
adenocarcinoma
one of the leading causes of death in the US
involves the exocrine portion of the gland
occurs more often in males 60-80 yrs old
increased incidence with smoking patients
adenocarcinoma signs
weight loss, abd/back pain, n/v, general weakness
60-70% found in pancreatic head, followed by body and tail
courvoisier gallbladder-dialated, palpable, non-tender gallbladder seen in 25% of patients, if mass is located in the head of pancreas
may also see liver mets, lymphnode involvement, ascites
other types of tumors
cystadenoma
cystadenocarcinoma
islet cell tumors
