Page created on September 19, 2018. Last updated on January 17, 2019 at 16:50
Staining: HE
Organ: Pancreas
Description:
We can see normal acinar cells. There are paler areas showing necrosis. We can also see neutrophils and RBCs.
Diagnosis: Acute pancreatitis with adiponecrosis
Theory:
Acute pancreatitis occurs when there is a blockage of the pancreatic duct, causing congestion that leads to pancreatic enzymes being activated inside the pancreatic parenchyme. These activated enzymes will then digest the pancreas, causing an acute inflammation.
Causes for pancreatic duct blockage can be:
- Bile stone
- Alcohol abuse (activates Oddi sphincter constriction, viscous pancreatitic secretion)
- Hypercalcemia
- Hyperlipidemia
- Chemotherapy
- Tumor
Acute pancreatitis has two phases. The first is the edematous phase and the second phase is the haemorrhagic phase. 80% of cases stop in the first phase, however it is the second phase that is life-threatening. It can cause sepsis, cardiac failure and ARDS, the latter of which can cause respiratory failure.
Neutrophils are present because there is an acute inflammation, while the RBCs shows that this slide is from the haemorrhagic phase of acute pancreatitis. The RBCs are released from the vessels as the vessels are digested by the pancreatic enzymes.
I wasn’t in the class when we went through this slide, so I don’t really know the details. Sorry.
Hello!
I need to say that what is actually missing on this description (and it is very important for the teacher at the exam!) is the main caracteristic of adiponecrosis : Saponification.
Saponification is when the fatty acids bind to Ca2+ to form soap.
In the middle of the slide we can see one calcified round pinkish area which is the proof of this phenomenon.
It is the most important clue for this slide for the examiner, it makes the difference between a 4 and a 5…
I hope this can help someone!
Thank you for your input! I can’t verify what you’re saying but I believe you.