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Pancreas Pathology Lab, Case 2

Pancreas Pathology Lab, Case 2. 47-year-old alcoholic man with severe epigastric pain radiating to the back. Identify the organ Identify the structures Diagnosis?. A – Fat necrosis B- Splenic vein and thrombus. Acute Pancreatitis The pancreas is bisected along its longitudinal axis.

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Pancreas Pathology Lab, Case 2

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  1. Pancreas Pathology Lab, Case 2 • 47-year-old alcoholic man with severe epigastric pain radiating to the back.

  2. Identify the organ Identify the structures Diagnosis?

  3. A – Fat necrosis B- Splenic vein and thrombus Acute Pancreatitis The pancreas is bisected along its longitudinal axis. Many foci of yellow-white necrosis are scattered throughout the head, body, and tail.

  4. Identify the organ Describe the histologic findings

  5. A – acinus B – Islet of Langerhans C – adipose cell Normal Pancreas

  6. Describe the histologic findings in sections A and B

  7. Section (A) reveals Acute Pancreatitis. The section shows amorphous debris (arrow) that formed after necrosis of acini. The few remaining acini (*) are separated by infiltrating neutrophils. Section B reveals normal pancreas for comparison

  8. Acute inflammation Acini acini Acute pancreatitis Amorphous debris

  9. Describe the histologic findings

  10. Fat necrosis Pancreas A low power view of peripancreatic fat shows necrosis

  11. Identify the organs Describe the gross morphologic changes Diagnosis?

  12. A – Stomach B – Spleen C – Fat D - Pancreas Acute Pancreatitis An autopsy specimen consisting of the stomach, spleen, pancreas, and adjacent fat reveals acute inflammation. The pancreas is swollen and hyperemic. Focal areas of green necrosis are present. Small foci of bright yellow, fat necrosis are present. The stomach is folded back so as to reveal its posterior wall and the pancreas.

  13. An intraoperative photograph reveals an acute hemorrhagic pancreatitis. The fat of the pancreas, colon, and greater omentum is necrotic and hemorrhagic

  14. Describe the gross findings Acute Hemorrhagic Pancreatitis A surgical specimen of the body and tail of the pancreas reveals acute, hemorrhagic necrosis.

  15. Describe the findings of this surgical specimen Acute Pancreatitis A surgical specimen of the transverse colon and greater omentum shows extensive fat necrosis (Note the bright yellow foci). The mesenteric fat has been completely digested away so as to reveal the isolated blood vessels.

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