Pancreas Powerpoint

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created 4 years ago by Brittanydms
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1
  • Autosomal dominant polycystic disease
  • Congenital cystic lesions of the pancreas
  • Cystic fibrosis
  • Fibrocystic disease of the pancreas
  • Von Hippel-Lindau syndrome
  • Solitary pancreatic cysts

Cystic Lesions of the pancreas? (6)

2

Exocrine

90

Pancreatic Neoplasms: Adenocarcinoma

Involves the ____ portion of the gland (ductal epithelium)

Most common primary neoplasm of the pancreas and accounts for more than __% of all malignant pancreatic tumors.

3

5, 4th

Pancreatic Neoplasms: Adenocarcinoma

Pancreatic carcinoma accounts for approx. ___% of all cancer deaths and is the ___ most common cause of cancer-related mortality after lung, breast and colon cancer.

4

Adenoncarcinoma

Poor

____ is rare before the age of 40; the majority of patients are older than 60.

Prognosis is ___, with a median survival time of 2-3 months and a 1 year survival of only 8%.

5

Location; head

25

Adenocarcinoma:

Symptoms- depend on the ____ of the tumor; tumors in the pancreatic ___ present symptoms early - cause obstruction of the CBD with subsequent jaundice and hydrops of the gallbladder

Palpable, non-tender gallbladder accompanied by jaundice (Courvoisier Sign) is present in ___% of patients with pancreatic carcinoma.

6

Body; tail

Large; invade

Adenocarcinoma:

Symptoms- Tumors in the ___ and ___ of the gland present with less specific symptoms - most common symptoms include weight loss, pain, jaundice, and vomiting as the GI tract becomes invaded by tumor.

Tumors are more frequently ___ in size and tend to ___ the adjacent organs such as the stomach, transverse colon, spleen and adrenal gland.

7

Microcystic; macrocystic

10-15; 1

Cystic Pancreatic Neoplasms:

2 types: ___ adenoma (serous cystadenoma) and ___ adenoma (mucinous cystadenoma/cystadenocarcinoma)

Cystic neoplasms of the pancreas account for less than __-__% of all pancreatic cysts and less than __% of all pancreatic malignancies.

8

Rare; women; large

Cystic Pancreatic Neoplasms: Microcystic Adenoma (serous cystadenoma)

___, benign disease found more often in ____. Tumor is well circumscribed and usually consists of a ___ mass with multiple tiny cysts.

9

Malignant; benign

Women

Body; tail

Septations

Cystic Pancreatic Neoplasms: Macrocystic adenoma (mucinous cystadenoma/cystadenocarcinoma

  • May be either ____ or ___ with a malignant potential.
  • Occurs predominantly in ____
  • Usually occurs in the ___ or ___.
  • Well-defined cysts contain thick mucinous fluid, internal ___, or mural nodules
10

Abdominal

Cystic Pancreatic Neoplasms: Macrocystic Adenoma

Clinically nonspecific abdominal symptoms: weight loss, ____ mass, or jaundice are presenting symptoms.

11

Mucinous cystic neoplasm

Main pancreatic duct

Men; women

Benign; malignant

Intraductal Papillary Mucinous Tumor

  • Form of ____
  • Originates from the ___ or its branches.
  • Slow growing lesion affects both ___ and ___ in the 6th&7th decades.
  • Histology ranges from ___ to ___
12

Islet

Functional; nonfunctional

Slow

Insulinoma; gastrinoma

Endocrine Pancreatic Neoplasms

  • Arise from ___ cells of the pancreas
  • Several types exist
  • May be ___ or ___
  • Benign adenomas or malignant tumors
  • Growth rate is ___
  • Usually do not spread beyond the regional lymph nodes and the liver
  • Most common functioning islet tumor is ___(60%), followed by ___ (18%).
13

Small

Hyperinsulinism, hypoglycemia

Endocrine Pancreatic Neoplasms: Insulinomas

  • Most are ___, well-encapsulated, with good vascular supply
  • Often occur in patients with ____ and ____.
14

Malignant

Multiple

Endocrine Pancreatic Neoplasms: Gastrinomas

  • Most are ____
  • Are frequently ___ and extrapancreatic
  • Are difficult to locate
15

Isolated

Triad

Lesions

Larger

Endocrine Pancreatic Neoplasms:

  • May be ___ or associated with the multiple endocrine neoplasia syndrome type 1 (MEN1)
  • MEN1 is characterized by the ___ of parathyroid, pituitary, and pancreatic lesions.
  • ___ may be solitary, multiple or diffuse.
  • Necrosis, hemorrhage, and calcification are seen more frequently in the ____ malignant type of islet-cell tumors.
16

Functioning

Benign

Clinical triad

Insulinoma (B-Cell Tumor):

  • Most common ___ islet cell tumor
  • Usually ___
  • ___ is found in patients in their 4th-6th decades with hypoglycemic symptoms with immediate relief of symptoms after the administration of intravenous glucose
  • Clinical symptoms - palpatations, headache, confusion, pallor, sweating, slurred speech, coma
17

Zollinger-Ellison

Gastrin

Stomach

Peptic Ulcer

Gastrinoma (G-Cell Tumor):

  • 2nd most common functioning islet cell tumor and produces the ___ syndrome.
  • Caused by non-insulin-secreting pancreatic tumors, which secrete excessive amounts of ____
  • Stimulates the ___ to secrete great amounts of hydrochloric acid and pepsin, which in turn leads to peptic ulceration of the stomach and small intestine
  • Lesions usually affect young adults who have ____ disease
18
  • Glucagonoma
  • Vipoma
  • Somatostatinoma
  • Carcinoid and multiphormonal tumors

Rare Islet-Cell Tumors? (4)

19

Glucagonomasa; vipoma

Vipomas

Rare Islet Cell Tumors:

  • Highest incidence of malignancy is found in ___ and ____
  • ___ are also associated with gallbladder dilation, fluid-filled distended bowel loops, and excessive secretion of fluid and electrolytes. Thickening of the gastric wall may also be present.
20

33

Large; malignancy

Nonfunctioning Islet-Cell Tumors

  • Make up ___% of all islet-cell neoplasms
  • Presentation tends to be ___ tumors in the head of the pancreas with a high incidence of ____.
21

10

METS to the pancreas:

  • Generally, METS to the pancreas is uncommon; reported in __% of patients with cancer.
  • Primary tumors that can metastasize to the pancreas include melanomas, breast, GI and lung tumors.
22

Malignant

Parapancreatic

Hypoechoic

SMV

Pancreatic Neoplasms: Lymphoma

  • ____ neoplasm
  • Most frequently a ____ neoplasm
  • Intraabdominal lymphoma may appear as a ____ mass or with necrosis, a cystic mass in the pancreas
  • ___ may be displaces anterior instead of posterior, as seen with a primary pancreatic mass
  • Multiple nodes are seen along the pancreas, duodenum, porta hepatis, and superior mesenteric vessels.
23
  • Lymphangiomas
  • Paragangliomas
  • Cystic Teratomas
  • Metastases

Parapancretic Neoplasms

Other retroperitoneal neoplasms? (4)

24

Thin; small

Thick; internal

Parapancreatic Neoplasms: Lymphangiomas

  • Most often ___-wall, homogeneous, ___ cysts
  • Also have been seen with septa, ___-walls, calcification and ___ debris
25

Children; young adults

Parapancreatic Neoplasms: Cystic Teratomas

  • Found more frequently in ___ and ___.
  • Their appearance is a mixed sonographic pattern of cystic, solid, fat and calcifications.