Module 1: Slide 27

• Acute pancreatitis

1. What is abnormal in this slide?

In the upper left we see hemorrhaging. Below this we find an area of tissue with massive infiltration of inflammatory cells, the eosinophilic dots, with no other visible cell structures as compared to the rest of the slide. Compmare this area with that of the acinar in the upper right hand corner which shows defined cells and structure.

2. Which enzymes are elevated in blood in this condition?

We would see an elevation of all the pancreatic enzymes - trypsinogen, CCK, lipase, elastase, and pancreatic amylase.

3. Where is the pancreas located?

Retroperitoneal, posterior to the stomach and duodenum.

Module 1 Slide 28

• Gross kidney specimen with caseous necrosis

1. What do these yellow-white lesions in the slide represent?

Yellow-white lesions are areas of caseous necrosis.

2. What does the term caseous mean?

It refers to the cheesy, white appearance of this particular type of necrosis. No distinct structure to the lesions.

3. Which disease is classically associated with this type of necrosis?

Tuberculosis

4. What happens to such lesions over a period of time?

Macrophage infiltration in an attempt to remove the necrotic tissue with only marignal efficiently. Over time it will take on an "onion" looking appearance with alternating layers of macrophages and necrotic tissue with a center of caseous necrosis.