Distinctive Pathology Associated With Focal Stenosis of the Main Pancreatic Duct Secondary to Remote Trauma: A Long-term Complication of Seat Belt Pancreatitis.
| Autor: | Wu AA; Departments of Pathology., Thompson ED; Departments of Pathology.; Oncology., Cameron JL; Surgery., He J; Surgery., Burkhart RA; Surgery., Burns WR; Surgery., Lafaro KJ; Surgery., Shubert CR; Surgery., Canto MI; Oncology.; Medicine (Gastroenterology)., Fishman EK; Radiology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD., Hruban RH; Departments of Pathology.; Oncology. |
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| Jazyk: | angličtina |
| Zdroj: | The American journal of surgical pathology [Am J Surg Pathol] 2024 Jun 01; Vol. 48 (6), pp. 726-732. Date of Electronic Publication: 2024 Mar 14. |
| DOI: | 10.1097/PAS.0000000000002207 |
| Abstrakt: | The radiologic finding of focal stenosis of the main pancreatic duct is highly suggestive of pancreatic cancer. Even in the absence of a mass lesion, focal duct stenosis can lead to surgical resection of the affected portion of the pancreas. We present four patients with distinctive pathology associated with non-neoplastic focal stenosis of the main pancreatic duct. The pathology included stenosis of the pancreatic duct accompanied by wavy, acellular, serpentine-like fibrosis, chronic inflammation with foreign body-type giant cell reaction, and calcifications. In all cases, the pancreas toward the tail of the gland had obstructive changes including acinar drop-out and interlobular and intralobular fibrosis. Three of the four patients had a remote history of major motor vehicle accidents associated with severe abdominal trauma. These results emphasize that blunt trauma can injure the pancreas and that this injury can result in long-term complications, including focal stenosis of the main pancreatic duct. Pathologists should be aware of the distinct pathology associated with remote trauma and, when the pathology is present, should elicit the appropriate clinical history. Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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