Novosti
Khirurgii

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Year 2016 Vol. 24 No 1

GENERAL & SPECIAL SURGERY

I.A. KRYVORUCHKO, N.Ì. GONCHAROVA, I.A. TARABAN, I.V. SOROKINA

THE FEATURES OF MORPHOGENESIS OF COMPLICATED PANCREATIC PSEUDOCYSTS

Kharkov National Medical University of the Ministry of Public health Ukraine
Ukraine

Objectives. To study the specific wall structural features of complicated pancreatic pseudocyst and pancreatic pseudocysts located within the pancreatic parenchyma by immunohistochemical techniques.
Methods. The features of pseudocyst morphogenesis using immunohistochemical methods have been studied in biopsies of patients (n=47) with complicated pancreatic pseudocysts.
Results. The predominance of type III collagen and the deficiency of type I collagen in the walls of type I pseudocysts and adjacent pancreatic parenchyma in the connective tissue component have been revealed; in the vascular component – deficiency of type IV collagen and weak capacity of endothelial cells to express receptors for endothelin-1. Predominance CD18 in the inflammatory infiltrates testified to favour of an acute inflammatory reaction with a marked tendency to fester. The ability of cellular pancreatic component to express receptors to HLADR–antigen was low. In the connective tissue component of pseudocysts type II the both types of collagens with a predominance of type III collagen over type I collagen have been identified.The microvessel walls of pseudocysts type II were presented by the basal membranes, containing type IV collagen and endotheliocytes located on the surface were able to express receptors for endothelin–1; lymphocytes CD3 and CD20 were dominated. The degree of receptor expression to HLADR–antigen was low. The predominance of type I collagen over type III collagen was considered to be the feature of pseudocysts type III. Basal membranes of microvessel walls of type III pseudocysts were thickened due to excessive accumulation of type IV collagen, leading to the reduced ability of the endothelial lining to express receptors for endothelin–1.
Conclusion. The appearance of type I collagen in the walls of pseudocysts type II is binded with maturation phase – type I collagen replaces type III, indicating a chronic process, i.e. as maturation continues pseudocyst type II developed in the connective tissue wall of pseudocysts type I. The high degree of expression of HLA DR-antigen indicated to the presence of an autoimmune link in the morphogenesis of type III pseudocysts.

Keywords: pseudocyst, pancreas, connective tissue, collagen, immune cells, chronic process, morphogenesis
p. 47-54 of the original issue
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Address for correspondence:
61022, Ukraine, Harkov, pr. Lenina, d. 4,
Harkovskiy natsionalnyiy meditsinskiy universitet,
kafedra khirurgii ¹ 2,
tel. office. 38 050 301-90-90,
e-mail: ikryvoruchko@mail.ru
Kryvoruchko Igor Andreevich
Information about the authors:
Kryvoruchko I.A. MD, professor, a head of the surgery chair ¹ 2 of Kharkov National Medical University.
Goncharova N.M. PhD, an applicant for Doctor’s degree of the surgery chair ¹ 2 of Kharkov National Medical University.
Taraban I.A. MD, professor of the surgery chair ¹ 2 of Kharkov National Medical University.
Sorokina I.V. MD, professor of the pathologic anatomy chair of Kharkov National Medical University.
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