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Histopathology > Y Lecture 6: Pancreas + Gallbladder > Flashcards

Y Lecture 6: Pancreas + Gallbladder Flashcards

1
Q

Recall the mnemonic for the causes of acute pancreatitis

A 
I GET SMASHED
Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hyperlipidaemia/hypercalcaemia/hyperparathyroidism 
ERCP
Drugs
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2
Q

Recall two causes of pancreatitis via duct obstruction

A 
Gallstones
Alcohol (via spasm/ oedema of Sphinter of Oddi)
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3
Q

Recall the pathophysiology of injury seen in acute pancreatitis

A
  1. Enzymes activated
  2. Acinar necrosis
  3. Enzyme release
    Can cause anything from stromal oedema to haemorrhagic necrosis
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4
Q

Why are yellow/white foci seen in acute pancreatitis?

A

Lipases cause fat necrosis

Calcium ions bind to free fatty acids forming soaps (which are white yellow)

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5
Q

What is a pseudocyst?

A

Dilated space with no epithelial lining

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6
Q

What is a cyst?

A

Dilated space lined by epithelium

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7
Q

Recall 2 pancreatic and 3 systemic complications of acute pancreatitis

A

Pancreatic: pseudocyst + abscess
Systemic: shock, hypoglycaemia, hypocalcaemia

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8
Q

Recall 4 complications of chronic pancreatitis

A

Malabsorption
Diabetes mellitus
Pseudocysts
Carcinoma of the pancreas

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9
Q

What is contained within a pancreatic pseudocyst?

A

Pancreatic enzymes and necrotic material (which is why it’s so bad when they perforate - it causes peritonitis)

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10
Q

Which immunoglobin is implicated in autoimmune acute pancreatitis?

A

IgG4

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11
Q

What type of cancer makes up 85% of pancreatic neoplasms?

A

Ductal carcinoma

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12
Q

What mutation is very common in ductal carcinoma?

A

K-Ras

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13
Q

What are the 2 types of precancerous dysplastic ductal lesions in the pancreas?

A
  1. PanIn (pancreatic intraductal neoplasm) 2. Intraductal mucinous papillary neoplasm
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14
Q

Which type of tumour has a “gritty and grey” macroscopic appearance?

A

Ductal carcinoma

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15
Q

Define adenocarcinoma

A

Mucin-secreting glands set in desmoplastic stroma (means: strong stromal reaction)

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16
Q

Recall 3 complications of ductal carcinoma

A
  1. Liver metastasis
  2. Chronic pancreatitis
  3. Venous thrombosis (“migratory thrombophlebitis”/ Trousseau syndrome) = mucin activating coagulation in circulatory system causing thrombosis
17
Q

Which type of pancreatic tumours are usually benign?

A

Cystic tumours

18
Q

Which type of pancreatic tumour is likely to contain neuroendocrine markers?

A

Pancreatic endocrine neoplasms

19
Q

Recall a neuroendocrine marker in pancreatic endocrine neoplasms

A

Chromogranin

20
Q

Which type of pancreatic tumour is associated with MEN1?

A

Pancreatic endocrine neoplasms

21
Q

What is the most common type of secretory pancreatic tumour?

A

Insulinomas

22
Q

In which portion of the pancreas are neuroendocrine tumours most common?

A

Tail

23
Q

What are the 2 types of gallstone?

A

Cholesterol

Pigment

24
Q

What do pigment gallstones contain?

A

Calcium salts of unconjugated bilirubin

25
Q

Which type of gallstones are radiolucent/radio opaque

A

Cholesterol: radiolucent
Pigment: radio-opaque

26
Q

Recall 4 potential complications of gallstones

A

Bile duct obstruction
Cholecystitis
Gall bladder cancer
Pancreatitis

27
Q

What is the most common cause of acute cholecystitis?

A

Gallstones (accounts for 90%)

28
Q

What is a key histopathological finding in chronic cholecystitis?

A

Diverticula Rokitansky-Aschoff sinuses

29
Q

What is the most common cause of gallbladder cancer?

A

Gallstones

30
Q

What are the 3 patterns of injury that may be seen in acute pancreatitis?

A

Periductal (necrosis of acinar cells near ducts) Perilobular (necrosis at the edges of lobules) Panlobular (develops from either of the above)

31
Q

What is IgG4 related disease?

A

A type of autoimmune disease that may affect the pancreas, surrounding structure or pretty much anywhere else in the body

32
Q

What are the 4 different types of pancreatic tumour?

A

Carcinomas: 1. Ductal 2. Acinar

Cystic neoplasms: 1. Serous cystadenomas 2. Mucinous cystic neoplasms

33
Q

What is the typical microscopic appearance of ductal carcinoma of the pancreas?

A

Desmoplastic stroma

Histopathology (10 decks)

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