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Gastrointestinal - Pathology > Pancreas and Peritoneal > Flashcards

Flashcards in Pancreas and Peritoneal Deck (36):
1

What results from the failure of dorsal and ventral pancreatic duct fusion?

Pancreas divisum

2

What is defined as a bandlike ring of normal pancreatic tissue completely encircling the second portion of the duodenum?

Annular pancreas

3

What is an ectopic pancreas?

Pancreatic tissue found in the stomach, duodenum, jejunum, meckel's diverticulum, and ileum. Usually very small

4

How do acute pancreatitis and chronic pancreatitis differ grossly?

Acute pancreatitis: Necrosis
Chornic pancreatitis: Fibrosis

5

How does chronic pancreatitis lead to pancreatic insufficiency?

Irreversible loss of acinar tissue

6

What pancreatitis may mimic pancreatic cancer on gross specimen?

Type I autoimmune pancreatitis

7

What is the histological problem in type I autoimmune pancreatitis?

IgG4 producing plasma cell increase

8

How do you treat autoimmune pancreatitis?

Steroid therapy

9

What are other diseases which may be manifestations of IgG4 disease?

Retroperitoneal fibrosis
Type 1 autoimmune pancreatitis
Reidel's thyroiditis
Chronic sclerosing sialadenitis (Kuttner's tumor) : a salivary gland tumor

10

What disease is analogous to sarcoidosis in its systemic organ manifestations by the same histopathological features?

IgG4 related disease

11

What are the two most common causes of pancreatic pseudocysts?

Acute pancreatitis
Trauma

12

What enzyme levels are high in pancreatic pseudocysts?

Amylase

13

What does the microscopic appearance of a pancreatic pseudocyst look like?

Lacks true epithelial lining and instead is lined by fibrin and granulation tissue

14

A older gentleman comes into your office with abdominal pain. A pancreatic tumor is resected, and his tumor had cysts with straw-colored fluid in them. It was a curative resection. What was the cyst?

Serous cystadenoma

15

A middle aged woman comes into your office with a mass in her belly that was painless. A cyst was removed from the tail of her pancreas. What is the likely cause? What do you have to worry about?

Mucinous cystadenoma
Worry about malignancy

16

An older gentleman comes into your office with a bump in his belly that was painless. CT examination shows a dilated duct system in the pancreas. What is the likely diagnosis and what do you have to worry about?

Intraductal papillary mucinous neoplasm
Worry about malignancy

17

Where does pancreatic cancer rank in the list of causes of cancer deaths?

Fourth leading cause

18

What are risk factors for pancreatic carcinoma?

Smoke
Physical inactivity
Diabetes
Chronic pancreatitis
Family hx
obesity

19

What are common clinical presentations of pancreatic carcinoma?

Pain, jaundice, cachexia, thrombophlebitis

20

How is pancreatic carcinoma diagnosed?

Imaging study, tissue bx
Often with endoscopic ultrasound guided biopsy technique

21

What is the whipple procedure?

Transect pancreas, take out duodenum and bile duct.
Attach stomach to jejunum, hepatic duct to jejunum, and pancreas to duodenum

22

What pancreatic cancer is most common in children?

Pancreatoblastoma

23

What cancer is most likely to be found in a young woman?

Pancreatic solid-pseudopapillary tumor

24

Where are pancreatic neuroendocrine tumors usually found? What about pancreatic adenocarcinoma?

PNT: body or tail
PA: Head

25

What do pancreatic neuroendocrine tumors look like? What about pancreatic adenocarcinoma?

PNT: Well circumscribed
PA: not well circumscribed

26

What is the clinical course of pancreatic neuroendocrine tumors like? What about pancreatic adenocarcinoma?

PNT: Long clinical course
PA: 1 year

27

What are some hormones that are released by pancreatic neuroendocrine tumors?

Insulin
Gastrin
Glucagon
Somatostatin
VIP
ACTH

28

What are some common causes of peritonitis?

Bacteria
Bile leakage
Hemorrhagic necrotizing pancreatitis
Foreign material
Endometriosis (localized hemorrhage)

29

What is defined as excess fluid in the peritoneal cavity?

Ascites

30

What is the most common cause of ascites? Second most common?

Portal hypertension
Cancer

31

What is the most significant complication of ascites?

Spontaneous bacterial peritonitis (bacterial infection without known source)

32

Why do you do a cell count with ascites?
Culture?
Albumin?
Total protein?
Cytology?

Cell count: infection
Culture: infection
Albumin: for serum ascites-albumin gradient
Total protein: if protein rich, then exudate
Cytology: Malignancy

33

If the SAAG is <1.1, what are the most likely causes of the ascites?

Cancer
TB
Pancreatitis
Nephrotic syndrome

34

If the SAAG is >1.1, what are the most likely causes of the ascites?

Cirrhosis
Hepatic mets
Bud-chiari syndrome
Cardiac disease

35

What two metastatic tumors are the most common causes of malignant ascites?

Ovarian carcinoma: #1
Pancreatic carcinoma: #2

36

What is idiopathic retroperitoneal fibrosis?

Dense fibrosing of the retroperitoneum causing ureter obstruction, dilating renal calyxes. IgG4 related