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Presented by Ralph Hruban, M.D. and prepared by Jeffrey Seibel, M.D. Ph.D.
Case 3: This 67 year old male with a history of alcohol abuse presented with severe back pain.
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1. Question
Week 87: Case 3
This 67 year old male with a history of alcohol abuse presented with severe back pain.images/042202case3a.jpg
images/042202case3b.jpg
images/042202case3c.jpg
images/042202case3d.jpgCorrect
Answer: Acute pancreatitis
Histology: This specimen shows the classical features of an acute pancreatitis. There is a marked mixed inflammatory cell infiltrate, fat necrosis, and destruction of pancreatic parenchyma.
Discussion: Acute pancreatitis is a group of reversible lesions characterized by inflammation of the pancreas, ranging from edema and fat necrosis to parenchymal necrosis, to severe hemorrhagic necrosis. Acute pancreatitis is relatively common. Most cases in the U.S. are caused by either biliary tract disease or alcoholism. Other causes include obstruction (neoplasms, pancreatic divisum, biliary sludge), infections (mumps, coxsackieviruses, and Mycoplasma pneumoniae), metabolic diseases (hypertriglyceridemia, hyperparathyroidism and other hypercalcemic states), ischemia (particularly due to vasculitis), trauma, and inherited conditions including germline mutations in the cationic trypsinogen gene (PRSS1).
Incorrect
Answer: Acute pancreatitis
Histology: This specimen shows the classical features of an acute pancreatitis. There is a marked mixed inflammatory cell infiltrate, fat necrosis, and destruction of pancreatic parenchyma.
Discussion: Acute pancreatitis is a group of reversible lesions characterized by inflammation of the pancreas, ranging from edema and fat necrosis to parenchymal necrosis, to severe hemorrhagic necrosis. Acute pancreatitis is relatively common. Most cases in the U.S. are caused by either biliary tract disease or alcoholism. Other causes include obstruction (neoplasms, pancreatic divisum, biliary sludge), infections (mumps, coxsackieviruses, and Mycoplasma pneumoniae), metabolic diseases (hypertriglyceridemia, hyperparathyroidism and other hypercalcemic states), ischemia (particularly due to vasculitis), trauma, and inherited conditions including germline mutations in the cationic trypsinogen gene (PRSS1).
