Module 2: Pancreas Pathology

Question 1

• Clinical signs ~6-12 months of age (exocrine pancreatic insufficiency)
• Lesions
  • Gross –small, inapparent pancreas
  • Histology –loss of exocrine acini (+/- lymphocytic inflammation)

Answer 1

Canine juvenile pancreatic atrophy
(Exocrine pancreatic atrophy)

Question 2

Pancreatic hypofunction:
Pancreatitis

Answer 2

Inflammatory Secondary targets (innocent bystanders)

Question 3

Release of exocrine pancreatic enzymes results in necrosis of both exocrine AND endocrine tissue

Answer 3

Acute necrotizing pancreatitis

Question 4

Relapsing, low-grade pancreatitis results in progressive destruction and loss of exocrine and endocrine parenchyma with fibrosis

Answer 4

Chronic pancreatitis

Question 5

This is likely a major cause of DM in dogs

Answer 5

Secondary loss of beta cells

Question 6

• May be a sequela to acute pancreatitis (especially with duct obstruction)
• May occur separately (subclinical or unassociated with acute pancreatitis)
• Gradual replacement of pancreatic parenchyma by fibrosis +/- associated inflammation
• In cats, chronic pancreatitis is associated with DM
• Gross lesions
• Nodular, firm pancreas that is often reduced in size (distinguish from nodular hyperplasia)
• Histologic lesions
• Interstitial and replacement fibrosis with lymphocytes and plasma cells (chronic inflammatory
cells)

Answer 6

Secondary loss of beta cells (“innocent bystander”)
(Chronic pancreatitis)

Question 7

Chronic pancreatitis is associated with _____________

Answer 7

Lymphocytic inflammation

Question 8

• Common in cats
• Age-related change
• Observed in normal cats and cats with diabetes mellitus
• However, ~20% of normal aged cats have this, whereas ~60% of cats with DM have islet
amyloidosis
• Protein is primarily amylin (islet amyloid polypeptide)
• May impinge on vasculature, resulting in islet dysfunction or degeneration
• Amylin deposition ≠ diabetes (but may be associated)

Answer 8

Islet amyloidosis

Question 9

weakness and wasting of the body due to severe chronic illness

Answer 9

cachexia

Question 10

fatty liver syndrome, occurs when triglycerides accumulate within the liver cells and obstruct the organ’s function

Answer 10

hepatic lipidosis

Question 11

Secondary lesions associated with diabetes mellitus (non-specific)

Answer 11

• Cachexia
• Cataract
• Hepatic lipidosis

Question 12

• Age-related change common in dogs and cats
• Several to dozens of variably-sized (usually no larger than ~3-5 mm) pale tan
nodules within parenchyma
• Of no clinical consequence

Answer 12

Exocrine nodular hyperplasia

Question 13

Which is much less common, glucagonoma or insulinoma?

Answer 13

glucagonoma

Question 14

• Most common islet-origin tumor
• Dogs and cats
• Middle-age to older animals
• Majority are malignant with microscopic metastasis at the time of diagnosis (therefore, carcinomas)
• Tend to metastasize via lymphatics →liver, regional lymph nodes
• Clinical signs due to the functional aspects of the tumors: Hypoglycemia →seizures, collapse, peripheral neuropathy

Answer 14

Beta cells (insulinoma, islet cell carcinoma)

Question 15

•Ferrets
• The most common neoplasm of ferrets (~25% of ferrets)
• Middle-age to older
• Generally benign (adenomas)
• Clinical signs: Hypoglycemia →weakness, trembling, hindlimb ataxia
• Surgical excision associated with common recurrence of hypoglycemia
• Therefore, surgery often paired with medical management

Answer 15

Pancreatic endocrine neoplasia

Question 16

•Exocrine pancreatic carcinoma
• Uncommon tumor of aged dog and cat
• Often associated with non-specific clinical signs:
• Weight loss (cachexia), vomiting, diarrhea
• Frequently diagnosed at a late stage, and prognosis is poor to grave
• Dissemination of neoplastic epithelial cells throughout abdomen is not
uncommon (carcinomatosis)

Answer 16

Pancreatic exocrine neoplasia

Question 17

Paraneoplastic diseases
* Most frequently associated with exocrine pancreatic carcinoma (sporadically associated with other carcinomas)
* Ventral and appendicular alopecia associated with “glossy” skin in cats with pancreatic carcinoma

Answer 17

Feline paraneoplastic alopecia