Challenges In Pancreatic Pathology

The assessment of the pancreas is a challenging problem because it has a profound location and it often presents difficulties in diagnosis and treatment. Despite many efforts in dealing with pancreatic diseases, the pathogenesis is not completely understood, the symptoms and imaging methods are unspecific, and the treatment possibilities are sometimes very limited. The major purpose of this book is to offer the reader a better understanding of the challenging aspects in pancreatic pathology, starting with anatomy and following with different pancreatic pathology. More space is allotted to pancreatic cancer, including surgical procedures, and to the management of the cystic lesions of the pancreas. This book is meant to provide a thorough guide for the best approaches in some of the difficult problems in pancreatology.

The pancreas is about the size and shape of the hand; the tail points to the spleen, and the head is nestled in a loop of the duodenum. Loss of the exocrine (digestive) func tions commonly leads to severe gastrointestinal disturbances, malabsorption, a cata bolic state, and weight loss in the face of an adequate diet. Loss of endocrine pancreatic function leads to a large spectrum of disorders associated with the loss of hormone secretions; the most common and most severe is diabetes mellitus. Loss of the entire pancreas owing to trauma, surgery, atherosclerosis, or other medical problems leaves the patient in a digestive and metabolic crisis. The correct diagnosis of pancreatic disorders remains a challenge given the multi faceted function of the pancreas. The clinical laboratory plays an important role, and other tools such as CAT scans, ultrasound, radiographs, biopsies, and even surgery are used to make a diagnosis. The emphasis of Clinical Pathology of Pancreatic Disorders is on the clinical laboratory definition of pancreatic pathology. Disorders of the endocrine pancreas can be highly complex, and sophisticated tests are needed to determine the nature of the disease, its prognosis, and its optimal treat ment. Diabetes is the most common of the endocrine diseases; it presents in many ways, and has varied etiologies. We now know that the diabetes of childhood is usually an autoimmune disease, and this has a major effect on the treatment of these individuals.

This book provides state of the art knowledge on a broad range of clinical issues in pancreatic cancer, covering topics from screening and pathophysiology to surgical treatments. In particular, the focus is on current controversies and on evidence-based surgical techniques. Further aspects considered include the management of precancerous lesions, diagnostic methods, perioperative care and nonsurgical treatment. The description of surgical methods is supported by many helpful illustrations and important technical issues are carefully addressed. Determination of resectability and extent of surgery is also discussed. Based on recent developments in surgical techniques, some surgeons are performing more and more radical operations. It is essential, however, that surgical strategy is based on the best available evidence and surgeons will find that this book offers valuable help in achieving this aim. In addition, it will be a great asset in clinical practice for all who are involved or interested in the management of pancreatic cancer.

Derived from 40 years' experience in diagnostic surgical pathology and autopsy rooms, this book deals with the gross and microscopic structure of the normal pancreas, placing a special focus on structural abnormalities. Updated information on congenital abnormalities and the effects of primarily non-pancreatic diseases upon this organ such as arterial diseases, makes this new Second Edition a indispensable addition to your library.

The second edition of this atlas focuses on imaging methods and techniques, new diagnostic concepts and therapeutic approaches in management of pancreatic neoplasms. Although interest in pancreatic pathology is very high in the radiological and gastroenterological communities, less is known about it than about, for example, liver pathology. Diagnosis depends on the structure of the pancreatic lesion, which can be directly visualized in US, CT or MR images. The book’s focus is very much on the imaging and pathological appearances, with most of the text concentrated at the beginning of the book followed by images gallery. A comprehensive overview is provided of typical and atypical presentations and diverse aspects of common and rare pancreatic tumors, including ductal adenocarcinomas with dedicated chapter to ductal adenocarcinoma downstaging, neuroendocrine neoplasms, cystic pancreatic neoplasms and intraductal papillary mucinous neoplasms. The Verona “Pancreas Centre,” the first institute of its kind in Italy and one of very few in the world, pursues an interdisciplinary approach to treating the problems of this organ, focusing on the patient, on research, and on teaching. A dedicated center that can look back on 40 years of tradition, many of its respected specialists have made essential contributions in surgery, gastroenterology, oncology, pathology, and radiology. Given its scope, this atlas will be an invaluable asset, helping radiologists understand the underlying pathology and helping pancreatic pathologists understand the imaging translation.

This expert volume in the Diagnostic Pathology series is an excellent point-of-care resource for practitioners at all levels of experience and training. Covering all areas of neoplastic and nonneoplastic diseases of the digestive tract and accessory organs such as the pancreas and liver, it incorporates the most recent clinical, pathological, and molecular knowledge in the field to provide a comprehensive overview of all key issues relevant to today’s practice. Richly illustrated and easy to use, Diagnostic Pathology: Hepatobiliary and Pancreas is a one-stop reference for accurate, complete pathology reports, ideal as a day-to-day reference or as a reliable training resource. Analyzes hundreds of diagnoses, each of which include critical diagnostic information such as definitions, epidemiology, clinical presentation, macro- and microscopic features, differential diagnoses, and pathologic interpretation pearls. Features thorough updates throughout, including novel immunohistochemical markers and other ancillary techniques (such as BAP1, INSM1, Rb, albumin in situ hybridization) that play an increasingly critical role in improving diagnoses Addresses recent advances in molecular pathology—new diagnostic, immunohistochemical, molecular, and genetic techniques used for diagnosis, as well as new details about the genesis and activity of tumors in the liver, pancreas, and biliary systems Includes details from the 2019 WHO Classification of Tumors of the Digestive System regarding important changes to diagnostic techniques, identification of new variants of cancers, and immunohistochemical markers and ancillary techniques that improve diagnosis and treatment options Reflects recent WHO updates and updates from the AJCC’s 8th Edition Cancer Staging Manual such as new terminology, new grading of neuroendocrine tumors and neuroendocrine carcinomas, and characteristic molecular alterations in hepatocellular adenoma, cholangiocarcinoma, and other tumors Uses a templated page layout, bulleted text, and a generous number of high-quality images to help practicing and in-training pathologists reach a confident diagnosis

This updated volume provides a practical guide to pancreatic pathology that covers recent changes in concepts and classifications. Potential pitfalls and mimics in pancreatic pathology are highlighted and illustrated, and guidance is provided regarding how to recognise and avoid them. There is a new chapter on transplant pathology, and more than 200 new macroscopic and microscopic images have been added. Pathology of the Pancreas: A Practical Approach aims to enable readers to recognise the various pathological entities and provide the key information in their pathology reports, which is necessary for the individual patient’s further management. The book provides the diagnostic pathologist with a comprehensive, well-illustrated, and extensively cross-referenced approach to pancreatic pathology.