Pancreas Pathology

Mind Map by , created almost 6 years ago

Doctorate Pathology (Systems Pathology) Mind Map on Pancreas Pathology, created by melian.yates on 11/06/2013.

Created by melian.yates almost 6 years ago
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Pancreas Pathology
1 Exocrine
1.1 Digestive
1.2 Proteolytic enzyme content can damage adjacent tissues
1.3 Structure
1.3.1 Lobules of exocrine pancreatic acini, separated by fine fibrous trabeculae
1.3.2 Cat One major pancreatic duct which shares a common entry into the duodenum with the common bile duct
1.3.3 Dog May be several major pancreatic ducts No common entry w/ the bile duct
1.4 Developmental Conditions
1.4.1 Pancreatic Acinar Atrophy Dogs Juvenile onset German Shepherds: Autosomal recessive inheritance Rough coated collies & English setters: Familial disease Likely autoimmune (Large #'s of lymphocytes & plasma cells targeting exocrine pancreas => Fibrosis) Islets of Langerhans are normal Most common cause of Exocrine pancreatic insufficiency (EPI) - Dogs Clinical signs by 6-12 months of age
1.5 Acquired Conditions
1.5.1 Exocrine pancreatic insufficiency Fatty diarrhoea (steatorrhoea) Insufficient lipase => undigested fat in diarrhoea => malabsorption sydrome Weight loss (Cachexia) Voracious appetite Pica, Coprophagia Concurrent small intestine bacterial overgrowth (SIBO)
1.5.2 Pancreatic calculi (Pancreolithiasis) Uncommon Incidental PM finding (Cattle)
1.6 Interstitial Pancreatitis
1.6.1 Acute Cats Systemic toxoplasmosis
1.6.2 Chronic Cats Often concurrent w/ Cholangitis & Enteritis (Triaditis) Extension of process that commences in the ducts Usually ascending infection of intestinal bacteria Also, migrating parasites Horses Histologically Hyperplasia of pancreatic ducts & periductular fibrosis & inflammation Can lead to exocrine pancreatic insufficiency/diabetes mellitus
1.7 Necrotising Pancreatitis
1.7.1 Acute Pancreatic Necrosis Imp. in Dog (Small breeds) Less common in Cats Activation of Trypsinogen => Trypsin w/in the pancreas => activation of cascade of pancreatic proenzymes leading to autodigestion & tissue damage Occurs due to fusion of zymogen granules with lysosomes Release of pancreatic enzymes into circulation => Hepatic necrosis, Pulmonary oedema, Interstitial pneumonia, Myocardial injury (& arrhythmias), Shock & DIC Dystrophic mineralization of necrotic abdominal fat (saponification) Necrosis of the pancreas, adjacent connective tissues & abdominal fat Blood vessels also involved => Haemorrhage, thrombosis, ischaemia Sequelae: Complete resolution (fibrosis & nodular regeneration) Chronic relapsing "smouldering" pancreatitis => Eventual complete loss Diabetes Mellitus (Destruction of Islets)
1.8 Nodular Hyperplasia
1.8.1 Common in older animals
1.8.2 Multiple nodules Raised, smooth, grey or white Non-functional
1.8.3 Often mistaken for Neoplasia
1.9 Neoplasia
1.9.1 Exocrine Adenomas Rare, Solitary
1.9.2 Exocrine Carcinomas Dog & Cat Single or multiple/confluent, firm, white or pale yellow nodules Non-functional Aggressive Invade adjacent tissues & pertoneum Metastasize to liver Obstruct bile flow => Jaundice
2 Endocrine
2.1 Metabolic
2.2 Structure
2.2.1 Islets of Langerhans (Small foci b/w acini) Alpha, beta, gamma, PP(F) & other cells
3 Pancreatic Disease:
3.1 Alimentary tract signs: Maldigestion
3.1.1 Concurrent biliary duct obstruction Jaundice (Cats - Triaditis) Metabolic Disease Endocrine pancreas