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Endocrine Pancreas - Pathology (view source)
Revision as of 10:43, 31 July 2008
, 10:43, 31 July 2008New page: {{toplink |backcolour = FAFAD2 |linkpage =Endocrine System - Pathology |linktext =Endocrine System |maplink = Endocrine System (Content Map) - Pathology |pagetype =Pathology }} <br> ==Anat...
{{toplink
|backcolour = FAFAD2
|linkpage =Endocrine System - Pathology
|linktext =Endocrine System
|maplink = Endocrine System (Content Map) - Pathology
|pagetype =Pathology
}}
<br>
==Anatomy and Physiology==
Anatomy and Physiology of the pancreas can be found [[Pancreas - Anatomy & Physiology|here]].
==Degenerative pathology==
===Aetiology===
*Hypoplasia of [[Pancreas - Anatomy & Physiology#Endocrine|panceatic islets]] where [[Pancreas - Anatomy & Physiology|exocrine]] cells are functional
*Degeneration of the [[Pancreas - Anatomy & Physiology#Endocrine|islet]] cells occurs in [[Pancreas - degenerative#Acute pancreatic necrosis|acute pancreatic necrosis]] along with acinar tissue necrosis, atrophy occurs during [[Pancreas - inflammatory#Chronic interstitial pancreatitis|chronic interstitial pancreatitis]]
*Extensive neoplastic destruction may also contribute to [[Pancreas - Anatomy & Physiology#Endocrine|islet]] loss
*Causes [[DM|Diabetes mellitus]] (DM)
*In cats
**'''Amyloidosis''' of the [[Pancreas - Anatomy & Physiology#Endocrine|islets]] is sometimes observed and may be restricted to just them
***May result in signs of [[DM|DM]] or have no symptoms
***[[General Pathology - Degenerations and Infiltrations#Vacuolar Degeneration|Hydropic (vacuolar) degeneration]] of beta cells
***Acumultion of glycogen within the cytoplasm
***Develops in response to long-term overstimulation due to peripheral insulin resistance
*In dogs
**'''Sclerosis''' of the islets is sometimes observed in dogs with [[DM|DM]] without pancreatic necrosis but also in dogs without DM
<br>
'''For degeneration of exocrine tissue''' see [[Pancreas - degenerative|'degenerative disease of exocrine pancreas in Alimentary section']]
==Neoplasia==
[[Image:Islet cell tumour.jpg|right|thumb|100px|<small><center>Islet cell tumour (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
===Insulin secreting neoplasms===
[http://w3.vet.cornell.edu/nst/nst.asp Images by Professor J.King]
*Adenomas and carcinomas deerived from beta cells
*Respond rapidly to iv glucose
*Can be identified by immunocytochemical means
*Dogs 5-12 years of age most commonly affected
*Older cattle, associated with periodic convulsions
====Clinical signs====
*Hyperinsulinism
*Hypoglycaemia - often episodic
**Neurologic signs - stupor, confusion, coma, seizures, peripheral neuropathy may also develop
===Adenomas (insulinomas)===
*Usually single, or less often multiple, small (1-3cm) spherical nodule, yellow to dark red, in one or more lobes
*Thin layer of fibrous tissue separates normal parenchyma
*Small islets of acinar tissue are sometimes present within the neoplasm
*Well differentiated cells
===Carcinomas===
*Larger than adenomas
*Multilobular
*Invasive into parenchyma and surrounding tissue
*Metastasis into [[Lymph Nodes - Anatomy & Physiology|lymph nodes]], [[Liver - Anatomy & Physiology|liver]] mesentery, omentum
*Few mitotic figures
===Gastrinoma===
[http://w3.vet.cornell.edu/nst/nst.asp Images by Professor J.King]
*Described in dogs, cats
*Known as Zollinger-Ellison syndrome in humans
*Uncommon compared to beta cell neoplasms
*Excess gastrin causes hyperacidity in the stomach and mucosal hyperplasia of the antral region causing gastric and [[Duodenum - Anatomy & Physiology|duodenal]] ulceration
====Clinical signs====
*Anorexia
*Severe weight loss
*[[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]]
*[[Diarrhoea]]
*Dehydration
====Pathology====
*Multiple variably sized neoplasms
*Increased connective tissue mass - firm
*Partiallty encapsulated
*Invade locally
*Metastases to [[Liver - Anatomy & Physiology|liver]] and local lymph nodes are common
===Glucagonoma===
*Very rare
*Characterised by
**Hyperglycaemia
**Vacuolar hepatopathy
**Skin erythema with superficial necrotising dermatitis
*Diagnosis in dogs is difficult as presents together with [[DM|DM]]
<br>
'''For hyperplastic and neoplastic disease of exocrine pancreas''' see [[Pancreas - hyperplastic and neoplastic|'hyperplastic and neoplastic disease of exocrine pancreas in Alimentary section']]
|backcolour = FAFAD2
|linkpage =Endocrine System - Pathology
|linktext =Endocrine System
|maplink = Endocrine System (Content Map) - Pathology
|pagetype =Pathology
}}
<br>
==Anatomy and Physiology==
Anatomy and Physiology of the pancreas can be found [[Pancreas - Anatomy & Physiology|here]].
==Degenerative pathology==
===Aetiology===
*Hypoplasia of [[Pancreas - Anatomy & Physiology#Endocrine|panceatic islets]] where [[Pancreas - Anatomy & Physiology|exocrine]] cells are functional
*Degeneration of the [[Pancreas - Anatomy & Physiology#Endocrine|islet]] cells occurs in [[Pancreas - degenerative#Acute pancreatic necrosis|acute pancreatic necrosis]] along with acinar tissue necrosis, atrophy occurs during [[Pancreas - inflammatory#Chronic interstitial pancreatitis|chronic interstitial pancreatitis]]
*Extensive neoplastic destruction may also contribute to [[Pancreas - Anatomy & Physiology#Endocrine|islet]] loss
*Causes [[DM|Diabetes mellitus]] (DM)
*In cats
**'''Amyloidosis''' of the [[Pancreas - Anatomy & Physiology#Endocrine|islets]] is sometimes observed and may be restricted to just them
***May result in signs of [[DM|DM]] or have no symptoms
***[[General Pathology - Degenerations and Infiltrations#Vacuolar Degeneration|Hydropic (vacuolar) degeneration]] of beta cells
***Acumultion of glycogen within the cytoplasm
***Develops in response to long-term overstimulation due to peripheral insulin resistance
*In dogs
**'''Sclerosis''' of the islets is sometimes observed in dogs with [[DM|DM]] without pancreatic necrosis but also in dogs without DM
<br>
'''For degeneration of exocrine tissue''' see [[Pancreas - degenerative|'degenerative disease of exocrine pancreas in Alimentary section']]
==Neoplasia==
[[Image:Islet cell tumour.jpg|right|thumb|100px|<small><center>Islet cell tumour (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
===Insulin secreting neoplasms===
[http://w3.vet.cornell.edu/nst/nst.asp Images by Professor J.King]
*Adenomas and carcinomas deerived from beta cells
*Respond rapidly to iv glucose
*Can be identified by immunocytochemical means
*Dogs 5-12 years of age most commonly affected
*Older cattle, associated with periodic convulsions
====Clinical signs====
*Hyperinsulinism
*Hypoglycaemia - often episodic
**Neurologic signs - stupor, confusion, coma, seizures, peripheral neuropathy may also develop
===Adenomas (insulinomas)===
*Usually single, or less often multiple, small (1-3cm) spherical nodule, yellow to dark red, in one or more lobes
*Thin layer of fibrous tissue separates normal parenchyma
*Small islets of acinar tissue are sometimes present within the neoplasm
*Well differentiated cells
===Carcinomas===
*Larger than adenomas
*Multilobular
*Invasive into parenchyma and surrounding tissue
*Metastasis into [[Lymph Nodes - Anatomy & Physiology|lymph nodes]], [[Liver - Anatomy & Physiology|liver]] mesentery, omentum
*Few mitotic figures
===Gastrinoma===
[http://w3.vet.cornell.edu/nst/nst.asp Images by Professor J.King]
*Described in dogs, cats
*Known as Zollinger-Ellison syndrome in humans
*Uncommon compared to beta cell neoplasms
*Excess gastrin causes hyperacidity in the stomach and mucosal hyperplasia of the antral region causing gastric and [[Duodenum - Anatomy & Physiology|duodenal]] ulceration
====Clinical signs====
*Anorexia
*Severe weight loss
*[[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]]
*[[Diarrhoea]]
*Dehydration
====Pathology====
*Multiple variably sized neoplasms
*Increased connective tissue mass - firm
*Partiallty encapsulated
*Invade locally
*Metastases to [[Liver - Anatomy & Physiology|liver]] and local lymph nodes are common
===Glucagonoma===
*Very rare
*Characterised by
**Hyperglycaemia
**Vacuolar hepatopathy
**Skin erythema with superficial necrotising dermatitis
*Diagnosis in dogs is difficult as presents together with [[DM|DM]]
<br>
'''For hyperplastic and neoplastic disease of exocrine pancreas''' see [[Pancreas - hyperplastic and neoplastic|'hyperplastic and neoplastic disease of exocrine pancreas in Alimentary section']]