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Anatomic pathology > Pancreas > Flashcards

Flashcards in Pancreas Deck (89)
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1

Chronic pancreatitis: Associations with pancreatic cancer.

Either one can cause the other; either one can mimic the other.

2

Chronic pancreatitis: Gross-pathology clues to alcoholic origin (2).

Pseudocyst.

Intraductal calculi.

3

Chronic pancreatitis: Possible confounding effects on islets of Langerhans (2).

Aggregations of islets may mimic neoplasm.

Islets may abut nerves.

4

Chronic pancreatitis: Helpful signs of benignity (2).

Preservation of lobular architecture.

No glands adjacent to muscular blood vessels.

5

Genes that predispose to chronic pancreatitis:

A. Names (2).
B. Other implications (2).

A. PRSS1, SPINK1.

B. Acute pancreatitis in childhood; pancreatic cancer.

8

Autoimmune pancreatitis: Histology (3).

Duct-centered lymphoplasmacytic infiltrate.

Interstitial fibrosis.

Venulitis.

9

Autoimmune pancreatitis: Treatment.

May respond to steroids.

10

Pancreatic pseudocyst: Outcomes (3).

Spontaneous resolution.

Infection.

Erosion into adjacent organs.

11

Pancreatic pseudocyst: Cytology (2).

Necrotic and hemorrhagic debris.

Hemosiderin-laden macrophages.

12

Pancreatic pseudocyst: Laboratory findings in cyst fluid.

Elevated amylase and CA19-9.

13

Lymphoepithelial cyst: Epidemiology.

M : F = 4 : 1.

14

Lymphoepithelial cyst: Gross pathology.

Thin wall; keratinous contents.

15

Lymphoepithelial cyst: Histopathology (2).

Lining composed of keratinized squamous epithelium.

Underlying lymphoid tissue.

16

Lymphoepithelial cyst: Main differential diagnosis.

Mature cystic teratoma also contains adnexal structures and sometimes cartilage.

17

Lymphoepithelial cyst: Clinical associations.

None demonstrated.

18

Serous cystic neoplasm: Epidemiology.

More common in women.

19

Serous cystic neoplasm: Association.

Von Hippel-Lindau syndrome.

20

Serous cystic neoplasm: Variants in gross pathology (4).

Microcystic.

Macrocystic.

Solid.

Association with well-differentiation neuroendocrine tumor.

21

Serous cystic neoplasm: Histopathology (3).

Lined by bland cells analogous to normal pancreatic serous cells.

Solid variant consists of the same type of cell.

Central scar (may be seen radiologically).

22

Serous cystic neoplasm: Special stain.

Positive for PAS, sensitive to diastase (contain glycogen).

23

Serous cystic neoplasm: Mutation.

Some tumors have a mutation involving VHL on chromosome 3p.

24

Serous cystic neoplasm: How to distinguish benign from malignant.

Serous cystadenocarcinoma: Extremely rare; diagnosed by its spread to other organs.

25

Mucinous cystic neoplasms: Epidemiology.

F : M = 20 : 1.

26

Mucinous cystic neoplasms: How many are malignant?

About one third.

27

Mucinous cystic neoplasms: Anatomic location (2).

Body or tail of pancreas.

No connection with the ductal system.

28

Mucinous cystic neoplasms: Histopathologic classification (4).

Noninvasive:
− Low-grade dysplasia.
− Intermediate-grade dysplasia.
− High-grade dysplasia.

Invasive: Cystadenocarcinoma.

29

Mucinous cystic neoplasm:

A. Stroma.
B. Cytokeratins (2).

A. Ovarian-like.

B. CK7 in most, CK20 in about ⅔.

30

Mucinous cystic neoplasms: Important gene.

Smad4/DPC4:
− Unmutated in most noninvasive tumors.
− Lost in about half of invasive tumors.

31

Mucinous cystic neoplasm: Other possibly mutated genes (3).

RNF43, KRAS2, TP53.

32

Intraductal papillary mucinous neoplasm: Epidemiology.

Slightly more common in men.