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| __NOTOC__
| | ==Physical examination== |
| {{Pancreatic cancer}} | | ==References== |
| {{CMG}}; {{AE}} {{Cherry}} | | {{reflist|2}} |
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| | {{WH}} |
| | {{WS}} |
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| | ==References== |
| | {{Reflist|2}} |
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| {| class="wikitable"
| | ===Pathophysiology prev=== |
| ! rowspan="2" |Disease
| | <div style="-webkit-user-select: none;"> |
| | rowspan="2" |Abdominal pain
| | {| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
| ! colspan="2" |History and Symptoms
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| | rowspan="2" |Fever
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| ! rowspan="2" |Physical examination
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| ! rowspan="2" |Laboratory findings
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| ! rowspan="2" |Imaging findings
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| ! rowspan="2" |Comments
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| |- | | |- |
| !Steatorrhea
| | | {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}} |
| !Weight loss
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| |- | | |- |
| |[[Chronic pancreatitis]] | | |} |
| |✔
| | __NOTOC__ |
| |✔
| | {{Cirrhosis}} |
| |✔
| | {{CMG}} {{AE}} |
| |<nowiki>-</nowiki>
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| | | | |
| |[[Diabetes mellitus|DM type II]], [[amylase]] and [[lipase]] levels may be slightly elevated
| | ===Pathophysiology prev=== |
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| | <div style="-webkit-user-select: none;"> |
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| | {| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
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| |Pancreatic cancer | | | {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}} |
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| |Ampullary carcinoma | | |} |
| | | | __NOTOC__ |
| | | | {{Cirrhosis}} |
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| | {{CMG}} {{AE}} |
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| | == History and Symptoms == |
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| | * History should include: |
| | | | ** Appearance of bowel movements |
| | ** Travel history |
| | ** Associated symptoms |
| | ** Immune status |
| | ** Woodland exposure |
| | ==References== |
| | {{reflist|2}} |
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| | {{WH}} |
| | {{WS}} |
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| | ==Other Imaging Findings== |
| | * [[Endoscopy]] |
| | * [[Barium enema]] |
| | * [[Colonoscopy]] |
| | * [[Sigmoidoscopy]] |
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| | ==Other diagnostic studies== |
| | == Other Diagnostic Studies == |
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| | * Breath hydrogen test |
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| | * [[HIV test]]ing for those patients suspected of having HIV |
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| | == |
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| | ==Overview== |
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| | ==References== |
| | {{reflist|2}} |
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| | {{WH}} |
| | {{WS}} |
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| | ===Pathophysiology prev=== |
| | <div style="-webkit-user-select: none;"> |
| | {| class="infobox" style="position: fixed; top: 65%; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
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| |Autoimmune pancreatitis | | | {{#ev:youtube|https://https://www.youtube.com/watch?v=5szNmKtyBW4|350}} |
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| |Lymphoma
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| |Pancreatic endocrine tumors
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| |Acute pancreatitis
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| |Cholangitis
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| |Biliary obstruction
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| |Pseudocyst
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| |Pancreatic duct stricture/stone
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| |Cholecystitis
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| |Chronic gastritis
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| |Community-Acquired Pneumonia (CAP)
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| |Intestinal perforation
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| |Crohn disease
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| |Myocardial infarction
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| |Mesenteric artery ischemia
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| |Peptic ulcer disease
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| |[[Retroperitoneal hematoma]]
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| |✔
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| |[[Anemia]]
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| |[[MRI]] is the best radiologic tool to differentiate between retroperitoneal masses.
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| |[[Retroperitoneal abscess]]
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| |✔
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| |✔
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| |[[Leukocytosis]], positive inflammatory markers
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| |Retroperitoneal tumors (.e.g. [[liposarcoma]])
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| |✔
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| |positive [[tumor marker]]
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| |} | | |} |
| | __NOTOC__ |
| | {{Cirrhosis}} |
| | {{CMG}} {{AE}} |
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| ==Treatment Options by Stage== | | ==Video codes== |
| ===Stages I and II Pancreatic Cancer===
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| Treatment of stage I and stage II pancreatic cancer may include the following:
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| * Surgery alone.
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| * Surgery with chemotherapy and radiation therapy.
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| ===Stage III Pancreatic Cancer=== | | ===Normal video=== |
| Treatment of stage III pancreatic cancer may include the following:
| | {{#ev:youtube|x6e9Pk6inYI}} |
| * Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
| | {{#ev:youtube|4uSSvD1BAHg}} |
| * Chemotherapy with gemcitabine.
| | {{#ev:youtube|PQXb5D-5UZw}} |
| | {{#ev:youtube|UVJYQlUm2A8}} |
|
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| ===Stage IV Pancreatic Cancer=== | | ===Video in table=== |
| Treatment of stage IV pancreatic cancer may include the following:
| | <div style="width:350px">{{#ev:youtube|5ucSlgqGAno}}</div> |
| * Chemotherapy with gemcitabine with or without erlotinib.
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| * Palliative treatments for pain, such as nerve blocks, and other supportive care.
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| * Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
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| ===Treatment Options for Recurrent Pancreatic Cancer=== | | ===Floating video=== |
| Treatment of recurrent pancreatic cancer may include the following:
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| * Chemotherapy.
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| * Palliative surgery or stent placement to bypass blocked areas in ducts or the small intestine.
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| * Palliative radiation therapy.
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| * Other palliative medical care to reduce symptoms, such as nerve blocks to relieve pain.
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| ===prevention=== | | {| class="infobox mw-collapsible" id="floatvideo" style="position: fixed; top: 65%; width:361px; right: 10px; margin: 0 0 0 0; border: 0; float: right;" |
| | | Title |
| | |- |
| | |- |
| | | {{#ev:youtube|https://https://www.youtube.com/watch?v=ypYI_lmLD7g|350}} |
| | |- |
| | |} |
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| Primary
| | ===Redirect=== |
| Cessation of cigarette smoking: The risk of pancreatic cancer falls with cessation of cigarette smoking, which is one of the most important modifiable risk factors.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid23921790">{{cite journal |vauthors=Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C |title=Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980 |journal=Ann. Oncol. |volume=24 |issue=10 |pages=2657–71 |year=2013 |pmid=23921790 |doi=10.1093/annonc/mdt301 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref><ref name="pmid14749618">{{cite journal |vauthors=Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP |title=Genetics and prevention of pancreatic cancer |journal=Cancer Control |volume=11 |issue=1 |pages=6–14 |year=2004 |pmid=14749618 |doi= |url=}}</ref><ref name="pmid14749618">{{cite journal |vauthors=Vimalachandran D, Ghaneh P, Costello E, Neoptolemos JP |title=Genetics and prevention of pancreatic cancer |journal=Cancer Control |volume=11 |issue=1 |pages=6–14 |year=2004 |pmid=14749618 |doi= |url=}}</ref><ref name="pmid12670518">{{cite journal |vauthors=Ghadirian P, Lynch HT, Krewski D |title=Epidemiology of pancreatic cancer: an overview |journal=Cancer Detect. Prev. |volume=27 |issue=2 |pages=87–93 |year=2003 |pmid=12670518 |doi= |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
| | #REDIRECT[[Esophageal web]] |
| Smoking accounts for the incidence of pancreatic cancer in one-fourth of all cases.<ref name="pmid25276995">{{cite journal |vauthors=Bochatay L, Girardin M, Bichard P, Frossard JL |title=[Pancreatic cancer in 2014: screening and epidemiology] |language=French |journal=Rev Med Suisse |volume=10 |issue=440 |pages=1582–5 |year=2014 |pmid=25276995 |doi= |url=}}</ref><ref name="pmid16127228">{{cite journal |vauthors=Qiu D, Kurosawa M, Lin Y, Inaba Y, Matsuba T, Kikuchi S, Yagyu K, Motohashi Y, Tamakoshi A |title=Overview of the epidemiology of pancreatic cancer focusing on the JACC Study |journal=J Epidemiol |volume=15 Suppl 2 |issue= |pages=S157–67 |year=2005 |pmid=16127228 |doi= |url=}}</ref>
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| Nicotine in cigarettes stimulates tumorigenesis, increasing metastasis and resistance to treatment, hence impacting survival in patients.<ref name="pmid25076322">{{cite journal |vauthors=Toki MI, Syrigos KN, Saif MW |title=Risk determination for pancreatic cancer |journal=JOP |volume=15 |issue=4 |pages=289–91 |year=2014 |pmid=25076322 |doi= |url=}}</ref>
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| The risk of developing pancreatic cancer becomes almost equivalent to that of a nonsmoker after five years of cessation.<ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
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| | ===synonym website=== |
| | https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008 |
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| Regular exercise:
| | ===Image=== |
| Obesity is considered as a potential risk factor for pancreatic cancer.<ref name="pmid22162231">{{cite journal |vauthors=Bracci PM |title=Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=53–63 |year=2012 |pmid=22162231 |pmc=3348117 |doi=10.1002/mc.20778 |url=}}</ref>
| | [[Image: Normal versus Abnormal Barium study of esophagus.jpg|thumb|left|200px|Normal versus Abnormal Barium study of esophagus with varices]] |
| Regular exercise decreases the risk of pancreatic cancer as compared to people living a sedentary lifestyle.<ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref><ref name="pmid25246281">{{cite journal |vauthors=Kollarova H, Azeem K, Tomaskova H, Horakova D, Prochazka V, Martinek A, Shonova O, Sevcikova J, Sevcikova V, Janout V |title=Is physical activity a protective factor against pancreatic cancer? |journal=Bratisl Lek Listy |volume=115 |issue=8 |pages=474–8 |year=2014 |pmid=25246281 |doi= |url=}}</ref>
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| The American Cancer Society (ACS) has issued guidelines for diet and physical activity at individual and community levels.
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| Diet:
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| A healthy balanced diet doesn't exceed 2000 calories daily and includes the following:<ref name="pmid10616684">{{cite journal |vauthors=Hart AR |title=Pancreatic cancer: any prospects for prevention? |journal=Postgrad Med J |volume=75 |issue=887 |pages=521–6 |year=1999 |pmid=10616684 |pmc=1741344 |doi= |url=}}</ref><ref name="pmid12670518">{{cite journal |vauthors=Ghadirian P, Lynch HT, Krewski D |title=Epidemiology of pancreatic cancer: an overview |journal=Cancer Detect. Prev. |volume=27 |issue=2 |pages=87–93 |year=2003 |pmid=12670518 |doi= |url=}}</ref><ref name="pmid28435395">{{cite journal |vauthors=Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD |title=Prevention of pancreatic cancer |journal=Contemp Oncol (Pozn) |volume=21 |issue=1 |pages=30–34 |year=2017 |pmid=28435395 |pmc=5385470 |doi=10.5114/wo.2016.63043 |url=}}</ref>
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| plenty of vegetables and fruits- blueberries, spinach, broccoli, tomatoes
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| lean meat from fowl, fish and plant sources like nuts or whole grains
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| monounsaturated fats help control insulin levels in type 2 diabetics<ref name="pmid19150414">{{cite journal |vauthors=Landi S |title=Genetic predisposition and environmental risk factors to pancreatic cancer: A review of the literature |journal=Mutat. Res. |volume=681 |issue=2-3 |pages=299–307 |year=2009 |pmid=19150414 |doi=10.1016/j.mrrev.2008.12.001 |url=}}</ref>
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| Tuna, mackerel, salmon, and sardine are major sources of long-chain omega-3 fatty acids due to anticancer properties
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| Poor diet: A poor diet includes the presence of the following:<ref name="pmid22162231">{{cite journal |vauthors=Bracci PM |title=Obesity and pancreatic cancer: overview of epidemiologic evidence and biologic mechanisms |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=53–63 |year=2012 |pmid=22162231 |pmc=3348117 |doi=10.1002/mc.20778 |url=}}</ref><ref name="pmid16549324">{{cite journal |vauthors=Lowenfels AB, Maisonneuve P |title=Epidemiology and risk factors for pancreatic cancer |journal=Best Pract Res Clin Gastroenterol |volume=20 |issue=2 |pages=197–209 |year=2006 |pmid=16549324 |doi=10.1016/j.bpg.2005.10.001 |url=}}</ref><ref name="pmid28435395">{{cite journal |vauthors=Kuroczycki-Saniutycz S, Grzeszczuk A, Zwierz ZW, Kołodziejczyk P, Szczesiul J, Zalewska-Szajda B, Ościłowicz K, Waszkiewicz N, Zwierz K, Szajda SD |title=Prevention of pancreatic cancer |journal=Contemp Oncol (Pozn) |volume=21 |issue=1 |pages=30–34 |year=2017 |pmid=28435395 |pmc=5385470 |doi=10.5114/wo.2016.63043 |url=}}</ref>
| | ===Image to the right=== |
| Food preservatives and additives
| | {| style="float: right; width: 350px;" |
| Smoked meat
| | | [[Image:Coxiella burnetii.JPG|right|400px|C. burnetii, the Q fever causing agent]] |
| Heavy alcohol use
| | |} |
| High cholesterol
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| Red meat
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| Low consumption of fruits and vegetables
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| Saturated fatty acids
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| Processed foods
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| high-fat, high-protein diet
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| Chemicals known as heterocyclic amines, nitrates, and heme iron, found in foods, are capable of damaging cells and DNA, influencing cancerogenic processes
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| Aging: Aging is associated with the development of pancreatic cancer.<ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid15051286">{{cite journal |vauthors=Li D, Xie K, Wolff R, Abbruzzese JL |title=Pancreatic cancer |journal=Lancet |volume=363 |issue=9414 |pages=1049–57 |year=2004 |pmid=15051286 |doi=10.1016/S0140-6736(04)15841-8 |url=}}</ref><ref name="pmid22162227">{{cite journal |vauthors=Bosetti C, Bertuccio P, Negri E, La Vecchia C, Zeegers MP, Boffetta P |title=Pancreatic cancer: overview of descriptive epidemiology |journal=Mol. Carcinog. |volume=51 |issue=1 |pages=3–13 |year=2012 |pmid=22162227 |doi=10.1002/mc.20785 |url=}}</ref>
| | ===Image and text to the right=== |
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| | <figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline>[[File:Global distribution of leptospirosis.jpg|577x577px]]</figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline> Recent out break of leptospirosis is reported in Bronx, New York and found 3 cases in the months January and February, 2017. |
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| Secondary
| | ===Gallery=== |
| Diet: Exocrine pancreatic insufficiency due to pancreatic duct obstruction by the tumor may lead to malabsorption.
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| Malabsorption in patients presents with anorexia, weight loss, and diarrhea.
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| Treatment: based on American Cancer Society(ACS) guidelines<ref name="pmid22237782">{{cite journal |vauthors=Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T |title=American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity |journal=CA Cancer J Clin |volume=62 |issue=1 |pages=30–67 |year=2012 |pmid=22237782 |doi=10.3322/caac.20140 |url=}}</ref>
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| Pancreatic enzyme replacement therapy
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| avoidance of high-protein/high-fat diets
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| Individualized dietary prescriptions from a registered dietitian
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| Supplementation with omega-3 fatty acids
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| === Palliative Therapy === | | <gallery widths="250px"> |
| * [[Pain]]:
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| ** There are various techniques for [[pain]] management as [[Palliative care|palliative therapy]] in patients with advanced stage of [[pancreatic cancer]]:
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| *** [[Narcotic]] [[Analgesic|analgesics]]
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| *** [[Narcotic]] [[Analgesic|analgesics]]+ [[Tricyclic antidepressant|tricyclic antidepressants]]/ [[Antiemetic|antiemetics]]
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| *** [[Radiation therapy]]
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| ==== Pain: ==== | | Pancreatic insulinoma histology 2.JPG|Histopathology of a pancreatic endocrine tumor (insulinoma). ''Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas''<ref name=aaa> Neuroendocrine tumor of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas</ref> |
| * There are various techniques for [[pain]] management as [[Palliative care|palliative therapy]] in patients.
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|
| |
|
| * Surgical techniques used to treat [[pain]] in advanced [[pancreatic cancer]] cases include:
| | Pancreatic insulinoma histopathology 3.JPG|Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. ''Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas''<ref name=aaa> Neuroendocrine tumour of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas</ref> |
| ** [[Endoscopy|Endoscopic]] [[decompression]] with [[stent]] placement in patients with [[Bile duct|biliary]] or [[pancreatic duct]] [[obstruction]]
| |
| ** [[Neurolysis]] of the [[celiac ganglia]] by many approaches:
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| *** Intraoperative
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| *** Transgastric
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| *** Transthoracic
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| *** Transabdominal
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|
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|
| ==== Jaundice: ====
| | Pancreatic insulinoma histology 4.JPG|Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. ''Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas''<ref name=aaa> Neuroendocrine tumour of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas</ref> |
| * [[Jaundice|Obstructive jaundice]] can present with features of [[cholangitis]]:
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| ** [[Fever]] and [[Rigor|chills]]
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| ** [[Nausea and vomiting|Nausea]], [[Nausea and vomiting|vomiting]]
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| ** [[Acholic stools|Clay-colored stools]]
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| ** Dark [[urine]]
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| ** Yellowish discoloration of skin
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| ** [[Itch|Pruritus]]
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| ** [[Abdominal pain|Right upper quadrant pain]]
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| ** [[Anorexia]]
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| * Preferred treatment in patients: [[Endoscopy|Endoscopic]] [[decompression]] with [[stent]] placement in patients with [[Bile duct|biliary]] [[obstruction]].
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| * Techniques of [[Bile duct|biliary]] [[decompression]]:
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| ** ''Cholecystojejunostomy''
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| ** ''Choledochojejunostomy''
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|
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|
| *Types of [[Stent|stents]]:
| | </gallery> |
| **Metal- costly, longer lifespan
| | ==References== |
| **Plastic- cheaper, need replacement every three months
| | {{Reflist|2}} |
| | {{WS}} |
| | {{WH}} |
|
| |
|
| ==== Duodenal obstruction ====
| | |
| * Preferred treatment:
| | REFERENCES |
| ** [[Endoscopy|Endoscopic]] [[Stent|stenting]] of [[Duodenum|duodenal]] [[obstruction]]
| |
| ** [[Gastrojejunostomy]]
| |
| <references /> | | <references /> |
| | |
| | [[Category:Gastroenterology]] |
| | [[Category:Needs overview]] |
| | [[Category:Hepatology]] |
| | [[Category:Disease]] |
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![Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/2/2f/Pancreatic_insulinoma_histology_2.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/a/a3/Pancreatic_insulinoma_histopathology_3.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/images/d/d5/Pancreatic_insulinoma_histology_4.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histology_2.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histopathology_3.JPG)
![Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas[1]](/index.php/File:Pancreatic_insulinoma_histology_4.JPG)