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Parenchymal GI Glands (Gallbladder, Biliary Tract, and Pancreas)

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Pathology of Childhood and Adolescence

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Abstract

The excretory biliary tract is one of the primary platforms of investigation for neonatal and infantile cholestasis. Some diseases linked to the gallbladder and extrahepatic biliary system of the childhood and youth are presented.

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Authors and Affiliations

  1. University of Alberta, Edmonton, AB, Canada

    Consolato M. Sergi

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Correspondence to Consolato M. Sergi .

Multiple Choice Questions and Answers

Multiple Choice Questions and Answers

  • PBL-1 The current classification of choledochal cyst lists five types. Match each type with the correct definition.

    1. (a)

      Type 1

    2. (b)

      Type 2

    3. (c)

      Type 3

    4. (d)

      Type 4

    5. (e)

      Type 5

    1. 1.

      One or more cysts of intrahepatic ducts (Caroli disease)

    2. 2.

      Segmental or diffuse fusiform dilatation of common bile duct

    3. 3.

      Dilatation of the intraduodenal common bile duct (choledochocele)

    4. 4.

      Diverticulum of common bile duct

    5. 5.

      Multiple cysts of extrahepatic bile ducts with or without cysts of intrahepatic ducts

      (a)(2) (b)(4) (c)(3) (d)(5) (e)(1)

  • PBL-2 An eosinophilic cholecystitis is an infrequent condition. Apart from the idiosyncratic reaction to biliary contents, it is less commonly observed due to other conditions. Which of the following conditions is NOT associated with eosinophilic cholecystitis?

    1. (a)

      Atopy

    2. (b)

      Hydrocortisone

    3. (c)

      Cephalosporin

    4. (d)

      Erythromycin

    5. (e)

      Hypereosinophilia syndrome

    6. (f)

      Parasitic infestation

  • PBL-3 A 15-year-old obese girl arrives at the emergency department of the children’s hospital with acute onset of severe abdominal pain following her dinner. Her abdominal pain is in the right upper quadrant. Which of the following symptoms is most specific for the diagnosis that you are considering for this patient?

    1. (a)

      Hemoccult-positive stool

    2. (b)

      Right upper quadrant pain with a wavy pattern, which last over hours

    3. (c)

      Abdominal wall, which is rigid and shows a diffuse rebound tenderness

    4. (d)

      Obesity-related epigastric post-prandial pain

  • PBL-4 Which immunohistochemical marker can be used to study the pancreas nerve innervation during the intrauterine development?

    1. (a)

      S100

    2. (b)

      NSE

    3. (c)

      Neurofilament

    4. (d)

      CD56

    5. (e)

      CD57

  • PBL-5 Which of the following is NOT a complication of primary sclerosing cholangitis?

    1. (a)

      Fat-soluble vitamin deficiencies

    2. (b)

      Metabolic bone disease (osteoporosis)

    3. (c)

      Cholangiocellular carcinoma

    4. (d)

      Gallbladder carcinoma

    5. (e)

      Dominant biliary strictures

    6. (f)

      Cholangitis

    7. (g)

      Cholelithiasis

    8. (h)

      Portal hypertension

    9. (i)

      Pancreas carcinoma

    10. (j)

      Hepatocellular carcinoma in patients with liver cirrhosis

    11. (k)

      Colon-rectal carcinoma in patients with concomitant ulcerative colitis

  • PBL-6 In the last couple of decades, binge drinking became the most common, costly, and probably deadly pattern of excessive alcohol use in the USA and Canada. Acute pancreatitis is a dreadful disease in children and adolescents and is not a rare condition anymore. All of the following conditions are associated with acute pancreatitis except one.

    1. (a)

      Alcohol ingestion

    2. (b)

      External trauma (e.g., car accident)

    3. (c)

      Internal trauma (e.g., abdominal surgery)

    4. (d)

      Diseases of the biliary tract

    5. (e)

      Alpha-1-antitrypsin deficiency

  • PBL-7 Which of the following characteristic pathologic features of the cystic fibrosis of the pancreas does NOT belong to this disease?

    1. (a)

      Accumulation of secretion

    2. (b)

      Acute pancreatitis

    3. (c)

      Dysplasia of the ductal epithelium

    4. (d)

      Exocrine pancreatic gland atrophy

    5. (e)

      Exocrine pancreatic gland atrophy with lipomatosis

    6. (f)

      Fibrosis with total obliteration of the exocrine glands and ducts.

  • PBL-8 The following statements correspond to pancreatoblastoma apart from which one?

    1. (a)

      Mixtures of acini and “squamoid corpuscles” with or without endocrine or ductal features

    2. (b)

      Highly cellular tumor with uniform epithelial cells in sheets and nests with acini/ducts

    3. (c)

      Hypercellular stroma

    4. (d)

      Bone/cartilage islands

    5. (e)

      Neuroblasts

  • PBL-9 Which of the following parameters is associated with a favorable prognosis for gallbladder carcinoma?

    1. (a)

      Papillary growth pattern

    2. (b)

      The small cell growth pattern

    3. (c)

      Angiolymphatic invasion

    4. (d)

      Tumor budding

    5. (e)

      Dedifferentiation

  • PBL-10 A 16-year-old girl presents with vague abdominal discomfort undergoes imaging, which reveals a pancreatic tumor. Histologic section of the resected mass shows solid areas with uniform cells surrounding capillary cores with the unique pseudopapillary formation in addition to necrotic/hemorrhagic cystic areas. The tumor cells are loosely cohesive, round to oval, and intermingled with eosinophilic hyaline globules. An immunohistochemical investigation reveals positivity for β-catenin expression (nuclear and cytoplasmic), loss of membrane staining (with nuclear localization) with E-cadherin, and lack of trypsin or chymotrypsin. Which of the following is the most likely diagnosis?

    1. (a)

      Pancreatoblastoma

    2. (b)

      Solid pseudopapillary tumor

    3. (c)

      Acinar cell carcinoma

    4. (d)

      Medullary carcinoma variant of pancreatic ductal adenocarcinoma

    5. (e)

      Hepatoid carcinoma variant of pancreatic ductal adenocarcinoma

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Sergi, C.M. (2020). Parenchymal GI Glands (Gallbladder, Biliary Tract, and Pancreas). In: Pathology of Childhood and Adolescence. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59169-7_5

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