Histology Course S I 6 Department of Pathology, University of Zurich Histokurs

S I 6 florid chronic ulcer HE further information (German) on HiPaKu
  ICD-10: K26.4

60-year-old male. Immigrant. Anaemia. Sudden death due to massive intestinal bleeding.

- The specimen shows the duodenal wall (Part D2) and the underlying pancreatic tissue.
- The epithelium of the duodenal mucosa is absent due to autolysis and the mucosal folds are only vaguely visible. Shown here is hyperplasia of the Brunner glands. Underneath the muscularis propria and (separated by some connective tissue) pancreatic tissue containing islets of Langerhans
- In one half of the specimen the duodenal mucosa is interrupted abruptly by ulceration, which extends past the muscular layer and penetrates the pancreatic tissue. At the bottom of the ulcer the four intertwining layers can be seen: exudates, necrosis, granulation tissue and scar tissue.
- The ulcer erodes a large artery, probably the gastro-duodenal artery.
Diagnosis Ulcer with erosion of an artery and penetration into the pancreas.