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J Clin Pathol. 1996 November; 49(11): 913–915.
PMCID: PMC500831

Histological assessment of chronic pancreatitis at necropsy.

Abstract

AIMS: To evaluate the histological criteria used to diagnose chronic pancreatitis; and to assess interobserver variation among general pathologists. METHODS: Forty five cases of chronic pancreatitis diagnosed in necropsy were reviewed to determine whether the diagnosis was acceptable retrospectively. These cases were diagnosed initially as chronic pancreatitis in the final necropsy report complied by general pathologists. In reviewing these cases, special attention was paid to irregular fibrosis and destruction of the lobular architecture. RESULTS: The 45 cases were re-assigned to seven different diagnostic categories: chronic pancreatitis, 21 (47%) cases; interstitial fibrosis with or without chronic inflammation, 11 (24%) cases; repair stage of acute pancreatitis, four (9%) cases; severe fatty infiltration, three (7%) cases; chronic inflammation without interstitial fibrosis, two (4%) cases; haemochromatosis, one (2%) case; and undetermined, three (7%) cases. CONCLUSIONS: The histological spectrum of chronic pancreatitis was very wide and it was often misdiagnosed. Acinar atrophy, acinar dilation and intralobular fibrosis were diagnostic of chronic pancreatitis. Differential diagnoses include the repair stage of acute pancreatitis, severe fatty infiltration and haemochromatosis. Recognition of these findings may help to reduce overdiagnosis of chronic pancreatitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Chari ST, Singer MV. The problem of classification and staging of chronic pancreatitis. Proposals based on current knowledge of its natural history. Scand J Gastroenterol. 1994 Oct;29(10):949–960. [PubMed]
  • Sarles H, Adler G, Dani R, Frey C, Gullo L, Harada H, Martin E, Norohna M, Scuro LA. Classifications of pancreatitis and definition of pancreatic diseases. Digestion. 1989;43(4):234–236. [PubMed]
  • Bozkurt T, Braun U, Leferink S, Gilly G, Lux G. Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis. Gut. 1994 Aug;35(8):1132–1136. [PMC free article] [PubMed]
  • CZERNOBILSKY B, MIKAT KW. THE DIAGNOSTIC SIGNIFICANCE OF INTERSTITIAL PANCREATITIS FOUND AT AUTOPSY. Am J Clin Pathol. 1964 Jan;41:33–43. [PubMed]
  • EDMONDSON HA, BULLOCK WK, MEHL JW. Chronic pancreatitis and lithiasis; a clinicopathologic study of 62 cases of chronic pancreatitis. Am J Pathol. 1949 Nov;25(6):1227–pl. [PubMed]
  • STEIN AA, POWERS SR., Jr Terminal pancreatitis. AMA Arch Pathol. 1958 Apr;65(4):445–448. [PubMed]
  • Shimizu M, Hayashi T, Saitoh Y, Itoh H. Interstitial fibrosis in the pancreas. Am J Clin Pathol. 1989 May;91(5):531–534. [PubMed]
  • Olsen TS. Lipomatosis of the pancreas in autopsy material and its relation to age and overweight. Acta Pathol Microbiol Scand A. 1978 Sep;86A(5):367–373. [PubMed]
  • Oertel JE. The pancreas. Nonneoplastic alterations. Am J Surg Pathol. 1989;13 (Suppl 1):50–65. [PubMed]

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