Histology of Pancreas & Gallbladder

Dr Muhammad Ressam Nazir

PANCREAS
The pancreas is an elongated structure that lies in the epigastrium and the left upper quadrant. It is soft and lobulated and situated on the posterior abdominal wall behind the peritoneum (RETROPERITONEAL). Has both Exocrine and Endocrine functions.

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PANCREAS

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PANCREAS
Exocrine Pancreas
Most of the pancreas is an exocrine gland. Pancreas is a compound tubuloalveolar gland of purely serous variety.

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ACINAR CELL OF PANCREAS

Pyramid-shaped acinar cells Rough ER: Abundant Basal Basophila. Apices are filled with secretory granules (zymogen granules). These granules contain the precursors of several pancreatic digestive enzymes that are secreted into the excretory ducts in an inactive form (TRYPSINOGEN, CHYMOTRYSINOGEN etc).

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Stroma of pancreas:
Thin C.T. capsule Septa divide the pancreas into lobules Within the lobules fine connective tissue surrounds the parenchymal units (acini). Exocrine pancreas has less blood supply than that of endocrine pancreas

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Excretory ducts
Start from within the center of individual acini as pale-staining centroacinar cells short intercalated ducts Intralobular ducts larger interlobular ducts main pancreatic duct.

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PANCREAS
Endocrine Pancreas
Scattered among the exocrine acini In human most numerous in tail of pancreas Pancreatic islets (of Langerhans)
Isolated, pale-staining vascularized units Each islet is surrounded by fine fibers of reticular connective tissue. With special immunocytochemical processes, four cell types can be identified in each pancreatic islet: alpha, beta, delta, and pancreatic polypeptide (PP) cells.
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Pancreatic Islet
These are richly vascularized spherical clusters (100-200 um) of Pale-staining cells. Cells are arranged in cords and clumps,
between which are found fine connective tissue fibers and a capillary network.

A thin connective tissue capsule separates the endocrine pancreas from the exocrine serous acini.
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Pancreatic Islet
Alpha (A) cells are 20% = Glucagon
The cytoplasm of alpha cells stains pink Location = peripheral Acts to elevate blood glucose level

Beta (B) cells are 70 % = Insulin

Cytoplasm of beta cells stains blue. Location = mainly central Predominate Acts to decrease blood glucose level.

Delta (D) cells are <5 % = Somatostatin

Least abundant Variable cell shape May occur anywhere in the pancreatic islet. Produce Inhibit the release of hormones by nearby cells and reduces the motility of GIT and gall bladder.
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Pancreatic Islet
G cells:
produce gastrin which stimulate gastric HCL secretion.

PP cells: Pancreatic polypeptide cells

Produce pancreatic polypeptide inhibits production of pancreatic enzymes and alkaline secretions.

Capillaries around the endocrine cells demonstrate the rich vascularity of the pancreatic islets.

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Regulation of Pancreatic secretions

Secretin and cholecystokinin (CCK) regulate pancreatic secretions.

Secretin
Causes the production of watery fluid rich in sodium bicarbonate ions (Alkaline!).
Neutralizes the acidic chyme

Cholecystokinin (CCK),
Fats and proteins in the small intestine is the stimulus for production. Stimulates the acinar cells to produce Digestive enzymes:
Pancreatic amylase for carbohydrate digestion

Pancreatic lipase for lipid digestion Deoxyribonuclease and ribonuclease for digestion of nucleic acids Proteolytic enzymes
Trypsinogen, Chymotrypsinogen, Procarboxypeptidase.
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PANCREAS- microscopic view

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GALLBLADDER

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GALLBLADDER
The gallbladder is a hollow, pear-shaped organ attached to the lower surface of the liver, capable of storing 3050 mL of bile.

Histology of gallbladder
The wall of gallbladder is composed of following three coats: 1. Mucosa 2. Muscularis 3. Avdentitia/serosa

1: Mucosa of gallbaldder
Mucosa is thrown into numerous temporary folds. These folds are particularly evident when the gallbladder is empty. Epithelium: simple columnar. No goblet cells. Small tubuloalveolar glands near the neck. Lamina propria: delicate reticular connective tissue. It is richly vascularized. No muscularis mucosa.

2: Muscularis of gallbladder
It is also called ad fibromuscular layer. It consists of a meshwork of interlacing bundles of smooth muscle fibers b/w which are present collagen and reticular fibers. Outer to the muscularis, dense irregular C.T is present called as perimuscular layer.

3: Adventitia/serosa of gallbladder
Superior surface which is attached to liver is covered by adventitia Elsewhere it is covered by peritoneum (serosa).

Functions of gallbladder
Storage of bile followed by emptying (function of cholecystokinin and ACh). Concentration of bile by reabsorption of water

I.D Points
Mucosal folds are present No muscularis mucosae Absence of goblet cells and crypts of Liberkuhn Fibromuscular layer Perimuscular layer Serosa