Pathology of endocrine pancreas

Pathology of endocrine pancreas 

Updated: 12/21/2020

© Jun Wang, MD, PhD

Anatomy/histology
  • Head, body and tail
  • Exocrine pancreas: Majority of pancreatic tissue, glandular epithelial cells
Predominantly at the head
Drain through pancreatic duct
Acini, ducts
  • Endocrine pancreas: Islets, pale endocrine cells
Alpha: secrete glucagon (20% 0f cells)
Beta: insulin (70% of cells)
Delta: somatostatin (5% of cells)
PP cells: pancreatic polypeptide
Physiology
  • Exocrine pancreas
Secrete digestive enzymes
Regulated by neural system (vagus) and humoral factors (secretin, cholecystokinin)
Proenzymes activated by trypsin
Self-digestion resulted by premature proenzyme activation causes acute pancreatitis
  • Endocrine pancreas
Glucagon: Promote glycogenolysis, elevate blood glucose
Insulin: Promote glucose utilization in tissue, reduce blood glucose
Somatostatin: Suppress alpha and beta cells
Pancreatic polypeptide: Secretion of gastrointestinal enzymes, reduce bowel motility
Diabetes mellitus
Acute complications of diabetes
Chronic complications of diabetes
  • Macrovascular diseases: Most common cause of mortality in long-standing diabetes
Myocardial infarction
Renal vascular insufficiency
Cerebrovascular accidents
  • Microvascular diseases:
Nephropathy
Retinopathy
Neuropathy
  •  Compromised immune function
Susceptibility to skin infections, tuberculosis, pneumonia, and pyelonephritis, etc
  • Others: Cataract, glaucoma, etc
Neoplasms
Practice questions 1
Practice questions 2


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