Histometric Features of Endocrine Islets of the Pancreas in Chronic Pancreatitis

Abstract

Long-existing chronic pancreatitis (CP) in the last stages of development leads to the destruction of the endocrine pancreatic tissue, but the mechanisms of these changes are not well understood. The aim of the study was to examine the qualitative and quantitative features of the histosctructure of insular apparatus of the pancreas at different stages of fibrosis in patients with CP. On the basis of comprehensive morphological and immunohistochemical study of surgical samples of the pancreas in patients with chronic pancreatitis we found that in the later stages of pancreatic fibrosis there are detected chronic hypoxia of parenchyma and compensatory reaction to it in the form of atrophy and metaplasia. Clinical course of chronic pancreatitis is characterized by consistent development of periductal, perilobular and intralobular fibrosis, which is accompanied by atrophy of acinar tissue. All this is a complex effect on the endocrine tissue. At later stages of pancreatic fibrosis, islet apparatus changes occur by type of atrophy, which is reflected in a decrease in the number of average islets and reduction of the total area of endocrine tissue and proliferation, resulting in an increasing number of small (mostly newly created) islets and tubular islet complexes.

Keywords

• pancreatic islets
• chronic pancreatitis
• fibrosis
• histometry