Histopathology of Pancreatic Fibrosis

The pancreas consists of lobules composed of the exocrine acinar and cen-troacinar cells and the endocrine islets of Langerhans, and a tree-like ductular system, which drains pancreatic juice excreted by acinar cells into the duodenum. Accordingly, the pancreatic lobules are the smallest structural unit of the pancreas. Pancreatic fibrosis is histopathologically subdivided into (1) interlobular fibrosis, (2) intralobular fibrosis, and (3) mixed fibrosis (fig. 1). However, intralobular fibrosis sometimes has interlobular elements and, when interlobular fibrosis progresses, it includes intralobular elements. In typical interlobular fibrosis, nodular pancreatic lobules remain with wide fibrotic areas in between. In contrast, intralobular fibrosis shows irregular or stellate-shaped thin or broad fibrotic areas within the lobules.

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