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This disease is characterized by the following morphological changes:(1) microvascular leakage causing edema, (2) necrosis of fat by lipases, (3) an acute inflammatory reaction, (4) proteolytic destruction of parenchyma,(5) destruction of blood

Acute pancreatitis (TOPNOTCH) Robbins Basic Pathology, 8th ed., pg. 677


Cardinal manifestation of acute pancreatitis

Abdominal pain(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 679


Necrosis of pancreatic tissue affecting acinar and ductal tissues as well as the islets of Langerhans; vascular damage causes hemorrhage into the parenchyma.

Acute necrotizing pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 678


Characterized by parenchymal fibrosis, reduced number and size of acini, and variable dilation of the pancreatic ducts. With relative sparing of Islets of Langerhans. Ductal concretions are present. SEE SLIDE 17.1.

Chronic pancreatitis(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 680


Presents as painless, slow-growing cystic masses filled with thick, tenacious mucin, lined with columnar mucinous epithelium, associated with densely cellular stroma. Almost always arise in women

Mucinous cystic neoplasm of the pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 681


Similar to mucinous cystic neoplasms but appear more frequently in men

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas(TOPNOTCH)Robbins Basic Pathology, 8th ed., pg. 682


Most common location of pancreatic cancer.

Head of pancreas. Usually causes jaundice due to common bile duct impingement (leading to earlier diagnosis relative to cancer in the body and tail) (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 654


Most common symptom of pancreatic carcinoma located at the tail and body of the gland?

None/AsymptomaticSince it does not impinge on the biliary tract, it may be quite large and widely disseminated by the time they are discovered.(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684


Moderately to poorly differentiated adenocarcinoma forming abortive tubular structures or cell clusters and exhibiting an aggressive, deeply infiltrative growth pattern. SLIDE 17.2.

Pancreatic carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684


Type of pancreatic carcinoma showing prominent acinar cell differentiation with zymogen granules and exocrine enzyme production

Acinar cell carcinomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684


Type of pancreatic carcinoma with focal squamous differentiation in addition to glandular differentiation.

Adenosquamous carcinomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p. 684


What is the most common clinically significant congenital anomaly of the pancreas?

Pancreas Divisum. SEE SLIDE 17.3. (TOPNOTCH)


This congenital abnormality develops embryologically when one portion of the ventral pancreatic primordium becomes fixed, while the other portion of this primordium is drawn around the duodenum

Annular Pancreas. SEE SLIDE 17.4. (TOPNOTCH)


The most common cause of acute pancreatitis is?

Excessive alcohol intake(TOPNOTCH)


5 morphological alterations in Acute pancreatitis

1. Edema caused by microvascular leakage2. Necrosis of fat caused by lipolytic enzymes3. Acute inflammatory reaction4. Destruction of pancreatic parenchyma by proteolytiz enzymes5. Destruction of blood vessels with subsequent interstitial hemorrage(TOPNOTCH)


The most common cause of chronic pancreatitis is?

Long term alcohol abuse(TOPNOTCH)


What is the most constant morphological feature of Chronic Pancreatitis?

Acinar Loss(TOPNOTCH)


60% of cancers of the pancreas arise in what area?

Head > Body > Tail(TOPNOTCH)


What is the most frequently altered oncogene in pancreatic cancer?



What is the most frequently inactivated tumor suppressor gene in pancreatic cancer?



What is the strongest environmental risk factor for developing Pancreatic Cancer?



What are the two characteristic features of Pancreatic Cancer?

Highly invasive and it elicits an intense non neoplastic host reaction called a desmoplastic response(TOPNOTCH)


Where do Pancreatic cancers usually metastasize?

Lungs and bones(TOPNOTCH)


What is the first symptom of pancreatic cancer?



These structures are formed by the walling off of areas of peripancreatic hemorrhagic fat necrosis with fibrous tissue and are usually composed of central necrotic hemorrhagic material rich in pancreatic enzymes

Pseudocyts. SEE SLIDE 17.5. (TOPNOTCH)


These kinds of cyst account for 75% of cysts seen in the pancreas



Morphology: Pancreas shows region of fat necrosis and focal pancreatic parenchymal necrosis

Acute pancreatitis(TOPNOTCH)


What is the most important triggering event in acute pancreatitis?

Activation of trypsinogen and subsequent autodigestion of the pancreatic substances(TOPNOTCH)


2 most common causes of acute pancreatitis

Biliary tract disease and alcoholism. (TOPNOTCH) Robbins Pathologic Basis of Disease, 9th ed., p. 884


A 32 y/o male presented with abdominal pain, nausea, and vomiting. Pain was described as constant and intense with radiation to the upper back. Lab result showed elevated plasma amylase. The clinical impression is:

Acute pancreatitis (TOPNOTCH)

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