Pancreas Flashcards
(32 cards)
What is the functional division of the pancreas?
Exocrine Pancreas and Endocrine Pancreas
Exocrine Pancreas constitutes 85% of pancreatic mass, while Endocrine Pancreas constitutes 2%.
What stimulates the secretion of the exocrine pancreas?
secretin, CCK, parasympathetic vagal discharge
CCK stands for cholecystokinin.
How many islets of Langerhans are typically found in a normal adult pancreas?
Nearly one million
Islet cells originate from neural crest cells, also known as APUD cells.
What percentage of pancreatic endocrine tumors are functional?
Approximately 80%
About 20% of pancreatic endocrine tumors are non-functional.
What defines malignancy in pancreatic endocrine tumors?
The presence of metastases.
Name a syndrome associated with pancreatic endocrine tumors.
MEN-1, von Hippel-Lindau, Neurofibromatosis.
What is the classification for a Well-Differentiated Endocrine Tumor Type 1?
Benign Behavior: Confined to the pancreas, <2 cm in diameter, <2 mitoses per high-power field, <2% Ki-67–positive cells, No vascular or perineural invasion.
What characterizes a Well-Differentiated Endocrine Carcinoma?
Low-grade malignant, gross local invasion, metastases.
What is the TNM classification for Tis?
Carcinoma in situ.
What is the most common type of pancreatic endocrine tumor?
Insulinomas.
What are the components of Whipple’s Triad in insulinomas?
Low glucose level (<50 mg/dL), symptoms of hypoglycemia, symptoms resolve with administration of glucose.
What is the average age at diagnosis for insulinomas?
45 years.
What is the primary treatment for symptomatic control in gastrinomas?
Octreotide.
What is Zollinger-Ellison Syndrome caused by?
Overproduction of gastrin from gastrinomas.
What characterizes VIPomas?
Profuse, watery, iso-osmotic secretory diarrhea, hypovolemia, hypokalemia, acidosis.
What is the laboratory finding that indicates glucagonoma?
Fasting glucagon level >1000 pg/mL.
What is the typical presentation of somatostatinoma?
Steatorrhea, cholelithiasis, diabetes, hypochlorhydria.
What is the clinical outcome for patients with nonfunctional pancreatic endocrine tumors?
5-year survival approximately 50%.
Which pancreatic endocrine tumors are classified as nonfunctional?
Pancreatic polypeptide–producing tumor (PPoma), Ghrelinomas.
What is the male-to-female ratio for VIPomas in adults?
1:3.
What is the typical age distribution for VIPomas?
Bimodal, with most patients being middle-aged.
What are the common clinical symptoms of glucagonoma?
Weight loss, hyperglycemia, migratory necrolytic dermatitis.
What is the characteristic appearance of insulinomas on imaging?
Encapsulated, firm, yellow-brown nodules that are typically hypervascular.
What is the surgical procedure for small insulinomas?
Tumor enucleation.
