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Systemic Pathology II > Pathology of the Exocrine Pancreas > Flashcards

Pathology of the Exocrine Pancreas Flashcards

1
Q

Structure of the Pancreas
1. Exocrine elements:
* ___-___% of pancreas
* Consists of ______ cells forming ____
2. Endocrine elements:
* ?

A

Structure of the Pancreas
1. Exocrine elements:
* 80-85% of pancreas
* Consists of acinar cells forming acini
2. Endocrine elements:
* Islets of Langerhans

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2
Q

Normal Pancreas
Two lobes:
* Left lobe
* Right lobe

Find other image

hit every quickly after death

A
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3
Q
  1. This is a histological image of what organ?
  2. Why is most of this structure eosinoohillic?
A

Why pink? Zymogen
- if not eating for awhile, very thin –> lack of zymogen –> lacking pink color

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4
Q

Label this image below.

A

When animal is eating –> zymogen granule production; depletion when not

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5
Q

Below is a histological image of what organ?

A

Pancreas!

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6
Q
A
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7
Q
  • In cats, the _________ bile duct fuses with the _________ duct before entering the _____ papilla.
    • Predispose cats to _____ (______, ________, _____)
  • Only ____% of cats are estimated to have an accessory pancreatic duct
A
  • In cats, the common bile duct fuses with the pancreatic duct before entering the major papilla.
    • Predispose cats to triaditis (cholangitis, pancreatitis, inflammatory bowel disease)
  • Only 20% of cats are estimated to have an accessory pancreatic duct
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8
Q

Cat or dog?

A
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9
Q

Cat or dog?

A

find real anatomy photos of cat and dog

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10
Q
A

Arrow pointing to: major duodenal papilla

GB top left, liver on top right

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11
Q
A

Found in the skin as well as the pancreas in cats

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12
Q
A

Looks like a fingerprint

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13
Q

Function of the Pancreas?

A
  1. Digestion (“pancreatic juice”)
    * Dietary lipids (lipase and phospholipase)
    * Proteins (trypsin and chymotrypsin)
    * Carbohydrates (amylase)
    * Intrinsic factor: essential for the absorption of cobalamin (vitamin B12)
  2. Defenses against autodigestion
    * α1-antitrypsin: trypsin inhibitor
    - inhibits trypsin so enzyme will not be digested? Relisten
  3. Zinc homeostasis
    * Therefore, pancreas has a comparatively high vulnerability to toxicity.

Loss or decrease cobalamin –> gut issues = IBD, etc.

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14
Q
  • Enzyme secretion is ___________ of the diet (e.g. ______, __________ etc.)
  • High protein diet → acinar cell ___________ or ____________
  • Low protein diet → acinar cell _______
A
  • Enzyme secretion is dependent of the diet (e.g. protein, carbohydrate etc.)
  • High protein diet → acinar cell hypertrophy or hyperplasia
  • Low protein diet → acinar cell atrophy
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15
Q
A

Exocrine pancreatic atrophy in a pig.

Depletion of zymogen granule, atrophy of acini
Example of starvation in a pig

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16
Q

What is the pathogenesis of pancreatitis?

A
  • Pathogenesis:
  • Pancreatic injury → release of pancreatic enzymes (esp.
    trypsin) into the surrounding parenchyma → further enzyme
    activation & autodigestion of the pancreatic tissue →
    necrosis & pancreatitis → inflammation

does not necessarily have to be inflammation of the pancreas, can also be necrosis of pancreas

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17
Q

What are the causes of pancreatitis?

A
  • Obstruction of the duct (s)
  • Direct injury to acinar cells
  • Disturbances of enzyme trafficking within the cytoplasm of
    acinar cells
18
Q

If you eat a high fat diet, pancreas is working hard to digest those ______.

A

if you eat a high fat diet, pancreas is working hard to digest those lipids.

19
Q

List the risk factors of pancreatitis in dogs?

A
  • Middle-aged to older dogs
  • Obesity
  • Miniature Schnauzers, Miniature Poodles, Yorkshire Terriers
  • High-fat diet
  • Drugs
  • Underlying diseases: Hyperadrenocorticism, hypothyroidism,
    hypertriglyceridemia
20
Q

What lesions will you typically see in a case of pancreatitis?

A

Lesions:
* Fat necrosis → saponification of fat
* Necrosis of blood vessels → thrombosis and hemorrhage
* Inflammation
* Fibrosis
* If ~90% of pancreatic tissue is loss, dogs may develop signs of
exocrine pancreatic insufficiency +/- endocrine pancreatic
insufficiency (diabetes mellitus)

  • loss of pancreatic tissue –> langerhaan cells –> insulin resistance –> exocrine pancreatic insufficiency and diabetes mellitus
21
Q

What are the systemic effects of acute pancreatitis?

A

Systemic Effects of Acute Pancreatitis
Secondary to the release of inflammatory mediators and
activated enzymes from the damaged pancreas
* Gastrointestinal signs (vomiting, diarrhea, anorexia)
* Hemorrhage
* Shock
* Disseminated intravascular coagulation
* Systematic inflammation
* Organ failure

22
Q
A
23
Q
A

Acute Pancreatic Necrosis, Acute Pancreatitis, Pancreas, Dog.

24
Q
A

Chronic Pancreatitis, Pancreas, Dog

25
Q

Describe the role of Inflammation in Acute Pancreatitis

  • _________ and __________ also play a key role in inflammatory response in acute pancreatitis.
  • FDA conditionally approves first drug to manage ______ onset of pancreatitis in _____ in Nov 2022:
  • Fuzapladib sodium monohydrate (fuzapladib): a ________ function-associated activation (LFA-1) _________ that blocks ________ extravasation.
A
  • Neutrophils and macrophages also play a key role in inflammatory response in acute pancreatitis.
  • FDA conditionally approves first drug to manage acute onset of pancreatitis in dogs in Nov 2022:
  • Fuzapladib sodium monohydrate (fuzapladib): a leucocyte function-associated activation (LFA-1) inhibitor that blocks neutrophil extravasation.
26
Q

Neutrophils are recruited to site of inflammation. Role in vessel via molecules expressed by endothelium. Neutrophil activated –> migrate through gap in endothelium –> enters pancreatic tissue.
This drug helps neutrophil go out to tissue by limiting excess ____________.

A

Neutrophils are recruited to site of inflammation. Role in vessel via molecules expressed by endothelium. Neutrophil activated –> migrate through gap in endothelium –> enters pancreatic tissue.
This drug helps neutrophil go out to tissue by limiting excess inflammation.

27
Q

Zinc Toxicosis

  • Source: _____ and ________ products (e.g. US _______), _______, _________
  • Clinical signs: ?
  • Histopathology: Acute _____ cell ______
A
  • Source: Alloys and galvanized products (e.g. US penny), pesticides, herbicides
  • Clinical signs: Vomiting, diarrhea, icterus, anemia, tachycardia, icterus, hemoglobinuria, hemoglobinemia, acute kidney and/or liver failure, pancreatitis, and DIC
  • Histopathology: Acute acinar cell necrosis
28
Q

What is pictured below?

A

Radiograph of a gastric foreign body (US penny) in a dog.

The penny will eventually be digested in the stomach so even though it is coated by copper on the surface, inside is Zinc.

29
Q

What can be seen in the image below?

A

Radiograph of a fowl bird with metal in the gastrointestinal tract

30
Q
A
31
Q
A

Zinc toxicity in a dog.
In the acute phase, there is basilar vacuolar degeneration within the acinar cells

32
Q

Exocrine Pancreatic Atrophy in Dogs
* Predisposed breeds: German shepherd dog and rough-coated
collies
* Cause: unknown; maybe autosomal recessive
* Clinical signs: maldigestion, diarrhea, malodorous feces, weight
loss, polyphagia, poor coat
* Gross: atrophied pancreas

A
33
Q
A

Juvenile pancreatic atrophy in a dog.

can not produce enzyme for animals to digest

34
Q

Hyperplasia
* Nodular hyperplasia of the pancreas: dogs, cats, cattle – no
clinical significance

A
35
Q

What condition is pictured below?

A

Pancreatic Nodular Hyperplasia, Exocrine Pancreas, Dog.
especially on older dogs –> it is this. no clinical significance

do histopath to confirm it is not neoplastic

36
Q

Neoplasia
1. Adenomas
- depends on size. hard to tell what clinical significance may be
2. Adenocarcinomas
- May extend to peritoneum, duodenum (called carcinomatosis; different from metstastis –> tumors travel through vessels or lymphatics; this term means when tumor is seeded through peritoneal cavity). Can do both!
- Metastasize to lymph node, liver, lungs
- poor prognosis

A

Neoplasia
* Adenomas
* Adenocarcinomas
* May extend to peritoneum, duodenum (carcinomatosis)
* Metastasize to lymph node, liver, lungs

37
Q
A

Pancreatic Carcinoma, Dog.

38
Q

What is pictured below?

A

Pancreatic adenocarcinoma with peritoneal carcinomatosis, unknown species

Seeding of neoplasia on omentum, throughout surface of organs in intestine. This is what you see in pancreatic carcinoma

39
Q
A

Peritoneal carcinomatosis due to hepatic carcinoma, Cat.

40
Q
A

Feline Paraneoplastic Alopecia
* Ventral truncal alopecia with a
shiny appearance to the skin.
- reason why it is shiny is b/c there is follicular atrophy
- do US to see if they have pancreatic or cholingier carcinoma
* Usually associated with
pancreatic carcinoma or
cholangiocarcinoma.

41
Q
A
42
Q

gross images, patterns for hepatitis, accumulation of stuff in cells, etc. focus on that
know function of cells we spoke abot i liver lecture
may give some clincl scenarios and ask what the Dx mght be ?

A

Systemic Pathology II (22 decks)

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