Pankreasın Benign Lezyonlarının Histopatolojisi
Özet
Pankreasın benign lezyonlarını ve neoplastik olmayan patolojilerini inceleyen bu yazı, akut ve kronik pankreatit başta olmak üzere çeşitli inflamatuar bozuklukları, kistik yapıları ve nadir görülen psödotümörleri kapsamlı bir şekilde ele almaktadır. Akut pankreatit, amilaz ve lipaz yüksekliği ile karakterize bir inflamasyonken; kronik pankreatit, parankimin fibrozis ile yer değiştirdiği ve ekzokrin yetmezliğe yol açan ilerleyici bir süreçtir. Yazıda ayrıca, IgG4 yüksekliği ile ilişkili olan otoimmün pankreatit, alkol ve genetik faktörlerle tetiklenen özel pankreatit formları ile psödokistler, lenfoepitelyal kistler ve skuamoid kistler gibi çeşitli kistik lezyonların histopatolojik özellikleri detaylandırılmaktadır. Nadir görülen nesidioblastozis, hamartom, malakoplaki ve lipomatöz psödohipertrofi gibi durumların, klinik ve radyolojik olarak maligniteyi taklit edebileceği vurgulanmaktadır. Sonuç olarak, pankreastaki bu neoplastik olmayan lezyonların doğru tanımlanması, hastaların gereksiz cerrahi müdahalelerden korunması ve duktal adenokarsinom gibi malign durumlardan ayırt edilebilmesi açısından kritik önem taşımaktadır.
This article examines benign lesions and non-neoplastic pathologies of the pancreas, comprehensively covering various inflammatory disorders, cystic structures, and rare pseudotumors, particularly acute and chronic pancreatitis. While acute pancreatitis is an inflammation characterized by elevated amylase and lipase levels, chronic pancreatitis is a progressive process where the parenchyma is replaced by fibrosis, leading to exocrine insufficiency. The text also details the histopathological features of autoimmune pancreatitis associated with high IgG4 levels, specific forms of pancreatitis triggered by alcohol and genetic factors, and various cystic lesions such as pseudocysts, lymphoepithelial cysts, and squamoid cysts. It is emphasized that rare conditions like nesidioblastosis, hamartoma, malakoplakia, and lipomatous pseudohypertrophy can clinically and radiologically mimic malignancy. In conclusion, identifying these non-neoplastic and pseudotumor-forming benign lesions in the pancreas is crucial for protecting patients from unnecessary surgical interventions and for differentiating them from malignant conditions, especially ductal adenocarcinomas.
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