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There are about 1 million islets distributed throughout the pancreas of a healthy adult human. While islets vary in size, the average diameter is about 0.2 mm. [5]:928 Each islet is separated from the surrounding pancreatic tissue by a thin, fibrous, connective tissue capsule which is continuous with the fibrous connective tissue that is interwoven throughout the rest of the pancreas.
The pancreas forms during development from two buds that arise from the duodenal part of the foregut, an embryonic tube that is a precursor to the gastrointestinal tract. [11] It is of endodermal origin. [11] Pancreatic development begins with the formation of a dorsal and ventral pancreatic bud. Each joins with the foregut through a duct.
The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan. [9] Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people. [10] Pancreatic ductal carcinoma is a common form of pancreatic cancer.
The ductal pancreas network originates from the central pancreatic duct—this main duct with the bile duct opens into the duodenum. The ductal cells of the main pancreatic duct are bound by connective tissue and produce a columnar epithelium. [3] Interlobular ducts originate from the main pancreatic duct and connect the various pancreatic lobes.
Chromogranin-A (CgA) or parathyroid secretory protein 1 is encoded in the human by the gene CHGA.Cga is a member of the granin family of neuroendocrine secretory proteins. As such, it is located in secretory vesicles of neurons and endocrine cells such as islet beta cell secretory granules in the pancreas.
Gross pathology: Main duct, branch duct, and mixed duct lesions, which determines surgical management. Main duct lesion is the segmental or diffuse dilatation of main pancreatic duct greater than 5 mm without other causes of obstruction. Meanwhile, branch duct lesion is the pancreatic cyst more than 5 mm that communicates with the main duct.
They are typically solid, soft masses. Under the microscope, at least two cell types are seen: cells with “acinar” differentiation, and cells forming small “squamoid” nests. The cells with acinar differentiation have some features of the normal acinar cell of the pancreas (the most common cell in the normal pancreas). [5]
Insulinoma is one of the most common types of tumours arising from the islets of Langerhans cells (pancreatic endocrine tumours). Estimates of malignancy (metastases) range from 5 to 30%. Over 99% of insulinomas originate in the pancreas, with rare cases from ectopic pancreatic tissue.