ABSTRACT
Fibrosis Pattern................................................................................. 331 16.2.1 Alcoholic Chronic Pancreatitis ........................................... 332 16.2.2 Hereditary Chronic Pancreatitis ......................................... 334 16.2.3 Autoimmune (Duct Destructive) Chronic Pancreatitis..... 335 16.2.4 Other Types of Pancreatitis ............................................... 337 16.2.5 Obstructive Chronic Pancreatitis........................................ 337
16.3 Conclusion........................................................................................ 339 References .................................................................................................. 340
Fibrosis in the pancreas is caused by processes such as primary chronic pancreatitis or pancreatic duct obstruction by neoplastic (e.g., pancreatic ductal adenocarcinoma) or nonneoplastic lesions. Its net result is always the formation of extracellular matrix (ECM) in the interstitial spaces and the acinar tissue, which may lead to replacement of the acinar cells and changes in the structure of the ducts and the arrangement and compo-
sition of the islets. The initial event that induces fibrogenesis in the pancreas is an injury to certain cellular elements such as the interstitial mesenchymal cells, the duct cells, or the acinar cells. Damage to one of these tissue compartments of the pancreas is associated with transformation of fibroblasts and pancreatic stellate cells into myofibroblasts and the subsequent production and deposition of collagen Type I and Type III and fibronectin.
