病理学经典图片集(胰腺)

Gross: These are cross sections taken through the head of the pancreas in chronic pancreatitis. The sections of pancreas which you have in your class sets were taken in a similar fashion. Notice that the dense white fibrous scarring has almost totally obliterated the lobular architecture of the pancreas.
The exocrine portion of the gland is most severely affected. There is almost total atrophy and fibrous replacement of pancreatic acini with relative preservation of the pancreatic ducts and islets of Langerhans (arrows). The intralobular pancreatic ducts are irregularly shaped and are embedded in chronically inflamed fibrous tissue. Several preserved islets are marked with arrows.
The fibrous scarring of the pancreas is highlighted with the Trichrome stain. The fibrous septa appear as blue bands surrounding the residual pancreatic lobules, which stain red.
This is a higher power view of a malignant gland. It is lined by pleomorphic cells which pile-up to form secondary lumina (gland-within-gland formation). Bridges of neoplastic epithelium grow across the major lumen of the gland (arrow).
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This low power view shows a moderately differentiated adenocarcinoma. Irregularly shaped malignant glands are embedded in chronically inflamed fibrous tissue. Adenocarcinomas of the pancreas typically excite this fibrous reaction in the surrounding tissue. When palpated, the tumor may be extremely hard, making it virtually impossible to differentiate from chronic pancreatitis.
Is a low power view of the glass slide in your class set. This is a section taken through the head of the pancreas from a patient with a duct cell adenocarcinoma. The viable tumor (T) is peripherally located. It shows a central area of necrosis (N). Immediately adjacent to the tumor, the pancreas shows chronic pancreatitis (large arrow). One normal pancreatic lobule (skinny arrow) is seen at the extreme right hand edge of the slide. The slide which you have contains a section taken through the extrapancreatic portion of the common bile duct (CD).
Shows the dense interstitial fibrosis surrounding two pancreatic lobules. Note there is also an increase in intralobular fibrous tissue and there is chronic inflammation.
Gross: This chronically inflamed pancreas is small and scarred. The dilated pancreatic duct contains a stone (arrow).
Plain film of abdomen: This is an example of chro来自百度文库ic pancreatitis with marked calcification of the pancreatic parenchyma.
病理学经典 图片集
Classical Photograph Of Pathology
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共和国二十一世纪第五个生日即将到来的时 刻，精心制作了这个图片集，其中涉及了大 量精美的、高质量的图片，并附带了大量而 且详尽的文字说明。值五一劳动节之际，把 它献给祖国，也献给奋战在医疗一线的战友。 2005.05.15
第二部分
Adenocarcinoma of the Pancreas
Gross: These are sections taken through a carcinoma of the head of the pancreas. The lesion is an ill-defined, tan-white mass which largely effaces the normal lobular architecture of the pancreas. The tumor blends imperceptibly into the surrounding pancreas and invades the wall of the duodenum. Two lymph nodes contain metastatic carcinoma. It may be virtually impossible for the surgeon in the operating room to distinguish carcinoma of the pancreas from chronic pancreatitis.
第一部分
Chronic Pancreatitis
Chronic pancreatitis is characterized by patchy fibrous replacement of whole lobules or parts of lobules, focal fat necrosis in different stages, and chronic inflammation. Grossly, depending on the degree of injury, the gland may have a normal outline, lobular pattern, and color but be slightly firm, or it may be smaller than normal, bosselated, rock-hard, and display foci of fat necrosis, calcification, or fully developed calculi.
This is a low magnification picture of the H&E slide of chronic pancreatitis in your class set. This particular patient had an obstructive type of pancreatitis due to carcinoma of the head of the pancreas. The lobular architecture of the pancreas is accentuated by the broad bands of interstitial fibrosis.
At higher magnification, note the nuclear pleomorphism of the neoplastic cells lining the glands.
Perineural invasion is extremely common in carcinoma of the pancreas. Unfortunately, infiltration into the peripancreatic fat, mesenteric vessels, duodenal wall, common bile duct, and other continguous structures such as the stomach, spleen, portal vein, peritoneal cavity is also common. Regional lymph node metastases are almost always present at the time of diagnosis.