Saved by the Cell
Odds & Endocrines
Shake it like a Polaroid picture
(p) NET Gains
Dead White Men
100
This substances inhibits both endocrine and exocrine pancreatic secretions
What is Somatostatin?
An inhibitory peptide found both in the hypothalamus as well as the pancreatic delta cells. it acts to suppress both endocrine release as well as exocrine secretions
100
This pancreatic cystic neoplasm is characterized by very high amylase, low CEA and negative mucin staining
What is pancreatic pseudocyst?
100
This sign is specific for this pathology.
What is Couvoursier's Sign, a sign of periamuplaary tumor
100
Octreotide scan is most useful for localizing this tumor
What is a Gastrinoma ?
Many pancreatic endocrine tumors have high concentrations of somatostatin receptors and can therefore be imaged with a radiolabeled form of the somatostatin analogue octreotide (indium-111 pentetreotide). Used in combination with EUS:, 90% of gastrinomas detected. It is also useful for localizing carcinoid tumors. localizing gastrinomas smaller than 1 cm. Somatostatinomas and VIPomas tend to be large bulky tumors and are thus readily seen by CT. - Octreotide scanning will miss as many as 40% of insulinomas because they may not express sufficient somatostatin receptors.
100
An American pathologist established this diagnostic triad consisting of fasting hypoglycemia, neuroglycopenic symptoms, and relief with glucose administration.
What is Whipple's Triad?
Allen Oldfather Whipple (1881–1963)
200
The location of the highest concentration of PP pancreatic polypeptide cells
What is the Head of the Pancreas?
Islets in the body and tail contain the majority of α-cells and few PP cells. This is clinically significant because pancreatoduodenectomy removes 95% of the PP cells in the pancreas which leads to glucose intolerance after the Whipple procedure then after distal pancreatectomy.
200
Multiple small cysts with internal septations, occasionally described as a "bunch of grapes" can sometimes be associated with this genetic syndrome
What is von Hippel-Lindau?
200
This is an ominous finding for this pathology.
What is sister Mary Joseph's nodule found in malignant metastatic GI cancer.
200
A 45-year-old woman presents with intermittent right upper quadrant pain, jaundice, and steatorrhea. Imaging shows gallstones and a mass in the pancreatic head. This type of pancreatic neuroendocrine tumor is classically associated with these findings.
What is a somatostatinoma?
Symptoms of steatorrhea and gallstones increase to likelihood of a somatostatinoma. They are most common in the proximal pancreas and 85% are usually metastatic at the time of presentation. The diagnosis is confirmed by an elevated fasting somatostatin level.
200
This accessory pancreatic duct, named after an 18th-century Italian anatomist, does not communicate with common bile duct, but rather drains directly into the duodenum and play a key role in pancreas divisum.
What is the Duct of Santorini?
Giovanni Domenico Santorini (1681–1737)
300
85% of the pancreas is made up of this type of cell
What are acinar cells?
300
This is the most common location of a heterotopic pancreas
What is the Duodenum
Usually asymptomatic may also occur in the gastric antrum, jejunum, ileum, and meckel's diverticulum - resection if symptomatic.
300
This sign is pathognomonic for this condition
What is fish mouth sign of IPMN
300
The most common location for a mass associated with dehydration, and weakness from fluid and electrolyte losses.
What is the Tail of the pancreas?
WDHA syndrome found in VIPoma is due to the presence of watery diarrhea, hypokalemia, and achlorhydria. Somatostatin analogues are helpful in controlling the diarrhea and allowing replacement of fluid and electrolytes.
300
in 1984 this American surgeon-researcher discovered that certain functional PNETS could be reliably found in THIS anatomic triangle of the pancreas—Superiorly by the Common bile duct medially by the Neck of the pancreas inferiorly: Third portion of the duodenum
What is Passaro’s Triangle?
Edward P. Passarp (1930 - 2017)
Also known as Gastronoma triangle as 90% of gastrinomas are thought to arise here
400
These cells found within the islets of Langerhans, are most pronounced in the uncinate process
What are F cells?
400
This carcinoma of the exocrine pancreas is distinct from the more common adenocarcinoma, and while its treatment is the same, it portends a much better prognosis
What is acinar cell carcinoma?
400
This condition is pathognomonic for this
What is Migratory necrolytic erythema of Gastronoma
400
A persistent skin rash of the lower abdomen and perineum, accompanied by a large mass in the tail of the pancreas is indicative of this syndrome caused by this pathology
What is necrolytic migratory erythema 2/2 to Glucagonoma?
New-onset diabetes in association with a skin rash and a pancreatic mass in the tail is highly suggestive of a glucagonoma. The rash is termed necrolytic migratory erythema and tends to manifest on the lower abdomen or perineum. -The diagnosis is confirmed by measuring glucagon levels. Fasting 500-1000pg/mL usually in the distal pancreas.
400
Characterized by watery diarrhea, hypokalemia and achlorhydria, patients with this syndrome are often found with VIP levels between 225-2000 pg/mL
What is Verner Morrison syndrome?
Drs. John V. Verner Jr. and Dr. Ashton B. Morrison
500
This is the pathologic feature of mucinous cystic neoplasm
What is ovarian-type stroma?
500
The appropriate surgical approach for 1.5-cm insulinoma located in the mid pancreas
What is Enucleation
90% of insulinomas are benign and solitary, and only 10% are malignant. <2cm are typically cured by simple enucleation. Tumors located close to the main pancreatic duct and large (>2 cm) tumors may require a distal pancreatectomy or pancreaticoduodenectomy. - check serum glucose level after resection to make sure you resected it.
500
What is mucinous cystic Neoplasm?
500
These markers are positive in neuroendocrine tumors.
What are chromogranin A and synaptophysin?
500
Pylorus preserving pancreaticoduodenectomy is also known as this binomial eponym
What is a Traverso-Longmire procedure?
Dr. William P. Longmire Jr. (1913–2003)