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There is actually nothing wrong with the pancreas from you patient. All of the changes you see are post-mortem autolysis, a common artifact that occurs when enzymes in the pancreas break down its histologic structure. Grossly the pancreas can be slight soft, but otherwise unremarkable. The tip off that this is a post-mortem event is the absence of inflammatory cells (which don't enter the tissue because, well, the patient is dead).
The "other" patient from lab 1 had HUS. In addition to the microthrombi found in the kidney, another complication of this disease is microthrombotic infarction of the pancreas leading to acute pancreatitis. There are many other causes of acute pancreatitis -- alcohol and gallstone being chief among them -- which be addressed next year. The common result of each is autolytic destruction (digestion) of the pancreas and surrounding fat, which induces an acute inflammatory response.
Although any tissue can undergo post-mortem autolysis, the pancreas, kidney, gallbladder, and intestines are the most frequently observed. Remember acute tubular necrosis from Lab 1? It can be very difficult to distinguish from post-mortem autolysis, unless you see an inflammatory response.
Histologically what do you see in each case?
Do you see inflammatory cells in either or both?
Could either or both have occurred post-mortem? Why?
What term would you use to identify the different pathologies?
Remember your patient from with Hemolytic Uremic Syndrome in Lab 2? He is the "other" patient. To see a CT of his pancreas and kidneys, click the icon.
Next you look at the pancreas from your patient.
How would you characterize the differences from the normal?
Do you see inflammatory cells?
Could the findings in your patient's pancreas have occurred post-mortem? Why?
What term would you use to identify this pathology?
On the next page we will compare your patient's pancreas to the pancreas of the boy with HUS from lab 2.
There is actually no pre-mortem pathology in the pancreas from you patient. All of the changes you see are post-mortem autolysis, a common artifact that occurs when enzymes in the pancreas break down its histologic structure. Grossly the pancreas can be slight soft, but otherwise unremarkable. The tip off that this is a post-mortem event is the absence of inflammatory cells (which don't enter the tissue because, well, the patient is dead).