Pancreas histology

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Pancreas histology

Module 6 - Endocrine System

Module 6 - Endocrine System

Bones of the neck
Deep structures of the neck: Prevertebral muscles
Deep structures of the neck: Root of the neck
Fascia and spaces of the neck
Superficial structures of the neck: Anterior triangle
Superficial structures of the neck: Posterior triangle
Anatomy of the lymphatics of the neck
Superficial structures of the neck: Cervical plexus
Endocrine system anatomy and physiology
Anatomy clinical correlates: Viscera of the neck
Anatomy of the abdominal viscera: Pancreas and spleen
Pancreas histology
Glucagon
Insulin
Diabetes mellitus
Diabetic nephropathy
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Diabetes mellitus: Pathology review
Obesity and metabolic syndrome: Clinical sciences
Anatomy of the diencephalon
Pituitary gland histology
Adrenocorticotropic hormone
Antidiuretic hormone
Oxytocin and prolactin
Growth hormone and somatostatin
Pituitary adenoma
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Diabetes insipidus and SIADH: Pathology review
Hyponatremia
Constitutional growth delay
Growth hormone deficiency
Hypopituitarism
Anatomy of the abdominal viscera: Kidneys, ureters and suprarenal glands
Adrenal gland histology
Cortisol
Synthesis of adrenocortical hormones
Glucocorticoids
Mineralocorticoids and mineralocorticoid antagonists
Congenital adrenal hyperplasia
Cushing syndrome
Cushing syndrome and Cushing disease: Pathology review
Adrenal hormone synthesis inhibitors
Primary adrenal insufficiency
Adrenal insufficiency: Pathology review
Hyperaldosteronism
Pheochromocytoma
Anatomy of the thyroid and parathyroid glands
Thyroid and parathyroid gland histology
Thyroid hormones
Hunger and satiety
Thyroglossal duct cyst
Hyperthyroidism
Graves disease
Thyroid eye disease (NORD)
Thyroid storm
Toxic multinodular goiter
Hyperthyroidism medications
Hypothyroidism
Hashimoto thyroiditis
Hypothyroidism medications
Postpartum thyroiditis
Thyroid cancer
Parathyroid hormone
Calcitonin
Phosphate, calcium and magnesium homeostasis
Vitamin D
Androgens and antiandrogens
Pituitary tumors: Pathology review
Hypopituitarism: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review

Transcript

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The pancreas is a large gland that has both exocrine and endocrine functions.

The majority of the pancreas consists of exocrine glands that produce about 1.5 liters of alkaline digestive enzymes daily, which is secreted directly into the duodenum.

The pancreas, also contains small endocrine cells found in clusters called islets of Langerhans, which typically stain lighter than the pancreatic tissue around it.

The pancreas has a thin collagenous capsule that surrounds the entire pancreas, although only portions of it can be seen in this image.

The capsule also extends into the pancreas as septa, forming lobules.

This section of the pancreas was prepared with Azan stain, which stains collagen blue-ish purple color in order to highlight structures such as the capsule, septa, as well as the connective tissue that surrounds large blood vessels.

Azan stain will also stain the connective tissue surrounding interlobular ducts a similar color as well.

But these ducts can be differentiated from the blood vessels by the presence of digestive enzymes instead of red blood cells within their lumen as well as their distinct epithelium that lines the lumen.

The epithelium consists of simple columnar cells in this image, but some ducts may also consist of stratified columnar or stratified cuboidal epithelium instead.

To the right of the interlobular ducts is an adipocyte.

The adipocytes actually increase in number within the pancreas as individuals age, which is a normal finding that’s caused by pancreatic atrophy over time.

The main functional tissue of the pancreas is called the parenchyma.

If we take a closer look at this slide stained with hematoxylin and eosin, or H&E for short, we can see that the majority of the parenchyma consists of the exocrine portion of the pancreas. The exocrine secretory cells are arranged in groups that resemble a berry surrounding a central lumen.

In latin acini means “berries,” which is why the groups of exocrine cells are called acini. we can see that the secretory cells are pyramid-shaped and their nuclei are found slightly closer to their bases.

This particular slide was stained with H&E, which allows us to see the purple, basophilic rough endoplasmic reticulum seen closer to the base of each secretory cell; and the pink eosinophilic secretory granules at the apices are inactivated enzymes called zymogens.

In acute pancreatitis, it’s the exocrine secretory cells that are damaged and end up releasing their enzymes into their immediate surroundings.

These strong digestive enzymes cause additional damage to pancreatic tissue and leads to severe inflammation as well.

The center of the acini will sometimes contain one or more cells with a paler appearance.

These cells are called centroacinar cells and they’re actually extensions of the small ducts that drain the digestive enzymes produced by the acini, called intercalated ducts.

The presence of centroacinar cells is a unique feature of the exocrine pancreas and is also an identifying marker that indicates the beginning of the intercalated ducts.

These ducts are lined by simple cuboidal epithelium and can be seen in this image as a linear arrangement of cuboidal cells.

Key Takeaways

The pancreas is an abdominal gland that has both exocrine and endocrine functions. Its exocrine part produces digestive enzymes in the small intestine, while its endocrine part produces hormones such as insulin and glucagon that regulate the body's blood sugar levels. Histologically, three main types of tissue make the pancreas: acinar cells, duct cells, and islet cells. Acinar cells produce enzymes and are secreted into the small intestine to aid digestion.

Duct cells line the pancreatic ducts and secrete a bicarbonate-rich fluid to neutralize stomach acid as it enters the small intestine. Islets of Langerhans produce hormones such as insulin and glucagon. In addition to these three main types of cells, the pancreas also contains supportive stromal cells and blood vessels. The stroma of the pancreas is composed of connective tissue that provides support, blood vessels, and nerve fibers.