presentazione standard di powerpoint...acute pancreatitis primary chronic pancreatitis secondary...
TRANSCRIPT
![Page 1: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/1.jpg)
Acute and Chronic PancreatitisIrene Esposito
Pancreatic pathology: Of mice and men
Madrid, December 4-6th 2014
![Page 2: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/2.jpg)
Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis
Classification
![Page 3: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/3.jpg)
Acute pancreatitis
Main causes: alcohol abuse – gallstones- drugsHereditary pancreatitis – autoimmune pancreatitis
![Page 4: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/4.jpg)
Clinic: Mild Morphology: oedematous APRelevance for pathologists: secondary phenomenon
- in resection specimens (e.g. after ERCP)- post-mortem
Acute pancreatitis
![Page 5: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/5.jpg)
Clinic: severeMorphology: necrotizing-haemorrhagic APRelevance for pathologists: necrosectomy
post-mortem
Acute pancreatitis
![Page 6: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/6.jpg)
oedema
vacuolisation
![Page 7: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/7.jpg)
Acinar tissue
Fat necrosis
![Page 8: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/8.jpg)
Acinar tissue
Necrosis
![Page 9: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/9.jpg)
Necrosis
![Page 10: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/10.jpg)
Necrotic-haemorrhagic pancreatitis
![Page 11: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/11.jpg)
Colliquative necrosis
![Page 12: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/12.jpg)
Complication: Pseudocyst
Cyst: hollow space with epithelial liningPseudocyst: hollow space without epithelial lining
![Page 13: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/13.jpg)
Summary
AP has different clinical presentations, ranging from mild forms to medical emergencies
AP is relevant for pathologists- as recurrent disease ( development of CP)- post-mortem
![Page 14: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/14.jpg)
Classification ofpancreatitis
Acute pancreatitis
Primary chronic pancreatitis
Secondary chronic pancreatitis
![Page 15: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/15.jpg)
Inflammation of the pancreas with irreversibledestruction of the exocrine parenchyma, fibrosis, and,in the late stages, destruction of the endocrineparenchyma
Definition
![Page 16: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/16.jpg)
Alcoholic Not alcoholic
HereditäryAutoimmuneIdiopathic, Tropical Metabolic (Hyperkalcemia, Hyperlipidemia) Obstructive
- Groove pancreatitis- Pancreas divisum- Tumors
Klöppel G, Mod Pathol 2007
Classificationof chronic pancreatitis
![Page 17: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/17.jpg)
Early stage Interlobular fat necroses
Parenchymal necroses
Klöppel G et al, Pathologe 2005
Morphology
![Page 18: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/18.jpg)
![Page 19: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/19.jpg)
Intermediate stage Interlobular fibrosis
Inflammation
Beginning intralobular fibrosis
Duct changes
Beginning acinar cell atrophy
![Page 20: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/20.jpg)
Fat necrosis InflammationFibrosis
![Page 21: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/21.jpg)
Van Gieson
Interlobular fibrosis
Intralobular fibrosis
![Page 22: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/22.jpg)
Late stage
• Inter- und intralobular fibrosis
• Destruction of exocrine tissue
• Dilated ducts
• Calcifications
• Prominent islets and nerves
![Page 23: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/23.jpg)
![Page 24: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/24.jpg)
![Page 25: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/25.jpg)
Eosinophilic ductalconcretion
![Page 26: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/26.jpg)
Destruction of exocrine tissue
![Page 27: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/27.jpg)
Long-standing obstruction of the main pancreatic duct
Main cause:
Tumor in the pancreatic head (PDAC)
Rare causes:
Concrements
Pancreas Divisum
Groove pancreatitis
Obstructive pancreatitis
![Page 28: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/28.jpg)
Inter- und intralobular fibrosis – Atrophy of acinar parenchyma–Dilated ducts – Slight chronic inflammation
Obstructivepancreatitis
![Page 29: Presentazione standard di PowerPoint...Acute pancreatitis Primary chronic pancreatitis Secondary chronic pancreatitis Inflammation of the pancreas with irreversible destruction of](https://reader034.vdocuments.net/reader034/viewer/2022043003/5f81a4ec946a7d54944134fc/html5/thumbnails/29.jpg)
Summary
- Long-term alcohol abuse is the most common cause of CP- Morphology gives important indications regarding aetiology- Secondary CP is in most cases caused by a tumor of the
pancreatic head