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Presented by Ralph Hruban, M.D. and prepared by Robert E LeBlanc, M.D.
Case 1: This middle-aged alcoholic underwent a pancreatoduodenectomy.
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Question 1 of 1
1. Question
Week 524: Case 1
This middle-aged alcoholic underwent a pancreatoduodenectomy.images/RHH5 01.jpg
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images/RHH5 04.jpgCorrect
Answer: Chronic pancreatitis
Histology: The pancreas was very firm. Histologically, prominent nerves are easily appreciated. In some instances acinar cells abut these nerves, raising the possibility of an acinar cell carcinoma.
Discussion: Neural hyperplasia is common in long-standing chronic pancreatitis. Islets of Langerhans and non-neoplastic acinar cells can abut and even involve these nerves, and in so doing mimic a neoplasm. In the case presented, the acinar cells near nerves lack atypia, retain an overall lobular growth pattern, and the lobules contain small ducts, establishing the non-neoplastic nature of the process.
Incorrect
Answer: Chronic pancreatitis
Histology: The pancreas was very firm. Histologically, prominent nerves are easily appreciated. In some instances acinar cells abut these nerves, raising the possibility of an acinar cell carcinoma.
Discussion: Neural hyperplasia is common in long-standing chronic pancreatitis. Islets of Langerhans and non-neoplastic acinar cells can abut and even involve these nerves, and in so doing mimic a neoplasm. In the case presented, the acinar cells near nerves lack atypia, retain an overall lobular growth pattern, and the lobules contain small ducts, establishing the non-neoplastic nature of the process.