SESSION II. Pathology of the
Pancreas
A. Congenital
anomalies:
1. Annular
pancreas
2. Aberrant pancreatic tissue
3. Cystic fibrosis:
a.
Autosomal recessive
b. CF gene: chromosome 7
c. 1/2000 White people
d. 50% mortality before age 21
e. High sodium and chloride in sweat
f. Thick mucus precipitates
g. Obstruction of:
-
pancreatic ducts: cystic dilatations
surrounded by fibrosis
- bronchi and bronchioles: bronchitis,
bronchiectasis, pneumonia
- bile ducts: cystic dilatations
h.
Congenital cysts
4. Diffuse
pancreatic islet hyperplasia
5. Absence of alpha cells
6. Zollinger Ellison Syndrome
B. Pancreatitis:
1. Acute
a.
Gallstones
b. Excessive alcohol consumption
c. Increased levels of:
-
Amylase in serum and urine
- Lipase in serum and urine
d.
Decreased levels of:
-
Serum calcium
- Insulin (hyperglycemia)
e.
Duodenal juice, low:
-
Volume
- Bicarbonate
- Amylase
- Trypsin
f. Stools,
high:
- Fat
- Nitrogen
g.
Pathology
-
Edema
- Congestion
- Hemorrhage
- Fat necrosis
- Necrotic abscess
- Gangrene
2. Chronic
C. Tumors:
1. Benign
a.
Cystadenoma
b. Duct adenoma
c. Islet cell adenoma (insulinoma)
2. Malignant
a.
Adenocarcinoma: head, tail
-
Acinar cell carcinoma
- Ductal
- Undifferentiated
b.
Cystadenocarcinoma
c. Islet cell carcinoma
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