Title:        Exocrine Pancreas
Date & Time:  Thursday, March 2, 2012 at 9 AM
Lecturer:     The Pathology Team

QUIZBANK Pancreas (all except #'s 1-8)

Liver / Pancreas
Taiwanese pathology site
Good place to go to practice

Photo Library of Pathology
U. of Tokushima

Pancreas Images
University of Washington
Pictures and comments

From Chile
In Spanish

Diseases of the Pancreas

Chaing Mi, Thailand

Pancreas Exhibit
Virtual Pathology Museum Interactive Pathology Museum

University of Connecticut

Pancreas Transplant Pictures
Great site
Transplant Pathology Internet Services

"Pathology Outlines"
Nat Pernick MD

Brown Digital Pathology
Some nice cases


{25019} normal pancreas, the white hamburger
{14887} normal pancreas, trichrome; no blue, so no dense fibrous tissue in the healthy pancreas.
{12463} islets of Langerhans (no, IZZ-lett is not really an acceptable pronunciation); H&E stain

{49140} annular pancreas; sideways, liver on left, pancreas extends across duodenum and gall bladder


{00044} cystic fibrosis; trichrome stain, showing dilated ducts plugged with good, and absent acini
{20204} hemochromatosis; Prussian Blue stain
{24505} hemochromatosis, gross, one's a Prussian blue
{24506} hemochromatosis, rusty color
{38848} hemochromatosis, rusty color. Scar tissue is white.

ACUTE PANCREATITIS ("soapsuds"; "chicken soup"; the classic term "rum belly" seems no longer in use; NEJM 330: 1998, 1994; Lancet 361: 1446, 2003 also describes chronic cases; update Lancet 371: 143, 2008; inflammatory mediation Surg. Clin. N.A. 87: 1325, 2007)

{39802} acute pancreatitis. Feels as bad as it looks.
{49232} ditto. Black area is a big hematoma.

Hemorrhagic pancreatitis
Autopsy specimen
KU Collection

Hemorrhagic pancreatitis
Urbana Atlas of Pathology

Enzymatic fat necrosis
White flecks
WebPath Photo

CMV pancreatitis

Yutaka Tsutsumi MD

{08339} enzymatic fat necrosis, gross; it is the chalky granular stuff. The background is hemorrhagic pancreatitis.
{08342} enzymatic fat necrosis, microscopic; left upper corner
{08348} enzymatic fat necrosis, microscopic

{49233} pseudocyst; spleen at right. Hollow and filled with fluid.

{49234} chronic pancreatitis; pale white is scar
{08853} chronic pancreatitis; extensive scarring
{20279} chronic pancreatitis in an alcoholic, nice protein plug
{46283} chronic pancreatitis with calculi
{49230} burned out alcoholic chronic pancreatitis, with calculi; the tube along the bottom is the splenic artery, twisting in and out

Chronic alcoholic Chronic obstructive
Lobules unevenly scarred All lobules in an area involved equally
Protein plugs in small ducts Few or no protein plugs
Perineural chronic inflammation Normal nerves


{49238} cystadenoma of the pancreas; has been cut in half and opened; spleen at right

CANCER OF THE PANCREAS ("cank of the pank", "the dismal disease", etc.; Lancet 378:607, 2011; Disease-A-Month 50: 545, 2004)

{08851} adenocarcinoma of pancreas; no normal pancreas on the slide; some glands are more anaplastic than others;
{26003} adenocarcinoma of pancreas; mucin-producer (pale apical cytoplasm, sharp borders)

Cancer of the pancreas
Primary and liver metastases
KU Collection

Pancreatic cancers
Wikimedia Commons

Nice guide to the differential diagnosis of a pancreatic tumor, for pathologists: Arch. Path. Lab. Med. 133: 454, 2009.

Eurytremiasis, the pancreatic fluke
Advanced students
Yutaka Tsutsumi MD