Difference between revisions of "Endocrine Pancreas - Pathology"

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<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 - Pathology#Acute pancreatic necrosis|acute pancreatic necrosis]] along with acinar tissue necrosis, atrophy occurs during [[Pancreas Inflammatory - Pathology#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 - Pathology|'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===
 
 
 
*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?Fun=Image&imgID=7762 Image of pancreatic garstrinoma in a dog 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]]
 
*[[Intestine Diarrhoea - Pathology|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 - Pathology|'hyperplastic and neoplastic disease of exocrine pancreas in Alimentary section']]
 

Latest revision as of 13:50, 9 June 2010