PERINEURAL LYMPHOID INFILTRATION IN CHRONIC PANCREATITIS, PANCREATIC ADENOCARCINOMA AND CHRONIC CHOLECYSTITIS

Objective: to study the quantitative and qualitative composition of perineural lymphoid infiltration in chronic pancreatitis and pancreatic cancer. Methods. The histological specimens of 28 patients with chronic pancreatitis, 12 patients with pancreatic cancer and 1 patient with chronic cholecystitis who had undergone the surgery of the head of pancreas were studied. Immunohistochemical expression of CD-45, CD-20, CD-5, CD-3 and CD-79 was studied in 14 cases (10 cases of chronic pancreatitis, 3 cases of pancreatic adenocarcinoma in chronic pancreatitis background disease and 1 case of chronic cholecystitis). Results. Hyperplasia and hypertrophy of nerve trunks in the pancreas and parapancreatic adipose tissue were detected in 26 of 28 cases of chronic pancreatitis, in 9 of 12 cases of pancreatic cancer and in 1 case of chronic cholecystitis. The perineural lymphoid infiltration was revealed in more than a half of the revealed cases. The considerable variability of qualitative and quantitative cell composition of perineural infiltrate was determined in chronic pancreatitis. Conclusion. The reparative hyperplasia and hypertrophy of nervous tissue is the consequence of primary enzymatic damage of myelin sheaths of nerves in pancreas during acute conditions of chronic pancreatitis. These changes of nerve trunks are accompanied by the development of an autoimmune response which is probably the cause of pancreatic pain in the period between exacerbations of chronic pancreatitis. The ratio of T-cells and B-cells in perineural infiltrate is probably caused by different duration of pathological process.

нервные стволы, периневральная лимфоидная инфильтрация, иммуногистохимический анализ, хронический панкреатит, рак поджелудочной железы, хронический холецистит, nerve trunks, perineural lymphoid infiltration, immunohistochemical study, chronic pancreatitis, pancreatic cancer, chronic cholecystitis

1. Neuropathology of chronic pancreatitis in humans / R. G. Keith [et al.] // Can. J. Surg. - 1985. - Vol. 28. - P. 207-211.

2. Vzaimosvyaz' porazheniya nervnoi tkani i fibroznykh izmenenii v golovke podzheludochnoi zhelezy s bolevym sindromom i kachestvom zhizni patsientov pri khronicheskom pankreatite / M. I. Kugaev [i dr.] // Novosti khirurgii. - 2011. - T. 19, № 5. - S. 39.

3. Porazhenie nervnykh stvolov pri khronicheskom pankreatite / O. V. Paklina [i dr.] // Annaly khirurgicheskoi gepatologii. - 2011. - № 3. - S. 95.

4. Nikitin, P. N. Izmeneniya nervnykh stvolov pri khronicheskom pankreatite / P. N. Nikitin, G. R. Setdikova, O. V. Paklina // VIII Vseross. Konf. po patologii kletki. Cb. nauch. tr. - M., 2010. - S. 169-170.

5. Vardanyan, M. Pathogenesis of Chronic Pancreatitis-induced Pain / M. Vardanyan, H. L. Rilo // Discovery Medicine [Elektronnyi resurs]. - 2010. - Vol. 9, № 47. - P. 304-310. Rezhim dostupa: http://www.discoverymedicine.com/Marina-Vardanyan/2010/04/10 pathogenesis-of-chronic-pancreatitis-induced-pain-2/. - Data dostupa: 30.10.2012.

6. Pancreatic neuropathy results in «neural remodeling» and altered pancreatic innervations in chronic pancreatitis and pancreatic cancer / G. O. Ceyhan [et al.] // Am. J. Gastroenterol. - 2009. - Vol. 104, № 10. - P. 2555-2565.