Pathological changes in pancreatic ducts from patients with chronic pancreatitis.
CONCLUSIONS
Chronic pancreatitis and restricted pancreatic outflow are accompanied by pathological changes in the ducts, including inflammation and alterations in the microvasculature. These changes and loss of epithelium provide a likely explanation for increased release of serum proteins, immunoglobulins, and lactoferrin into the juice, and the possibility of luminal contents entering the extracellular space and bloodstream.


BACKGROUND
Enlargement of pancreatic ducts is a well-known phenomenon accompanying chronic pancreatitis and conditions restricting outflow of pancreatic juice. However, the relationship between ductal pathology and concomitant changes in the pancreatic juice is incompletely understood.


METHODS
Segments of pancreatic ducts removed at surgery from patients with chronic pancreatitis and conditions restricting outflow were studied by light and electron microscopy to assess the pathological changes.


RESULTS
Pathological changes in ducts from patients with chronic pancreatitis include chronic inflammation in the wall, enlarged and numerous capillaries packed with erythrocytes and leukocytes close to the lumen, and loss of epithelium and sometimes basement membrane. Plasma cells provide a source for increased immunoglobulins. Ducts from patients with diseases restricting outflow show significant pathology.
Bockman
D E
DE
Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta 30912-2000, USA.
Muller
M
M
Büchler
M
M
Friess
H
H
Beger
H G
HG
D016022:Case-Control Studies; D002908:Chronic Disease; D004848:Epithelium / Q000473:pathology; D006801:Humans; D008854:Microscopy, Electron; D008855:Microscopy, Electron, Scanning; D010183:Pancreatic Ducts / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D010189:Pancreatic Juice / Q000737:chemistry / Q000378:metabolism; D010195:Pancreatitis / Q000473:pathology*