Histologi Hepatobilier Dan Pankreas

Histology of Hepatobilliary and
Pancreas
dr. Ira Cinta Lestari, M.Sc
Histology Dept.
Medical Faculty
Univesitas Islam Sumatera Utara
Liver (Hepar)
The body's biggest organ, weighing about 1.5 kg or about 2% of an adult's
body weight.
The largest gland and is situated in the abdominal cavity beneath the
diaphragm.
Function :
Gathering, transforming, and accumulating metabolites from blood and
for neutralizing and eliminating toxic substances in blood.
The elimination occurs in the bile, an exocrine secretion of the liver that
is important for lipid digestion in the gut.
Produces plasma proteins such as albumin, fibrinogen, and various
carrier proteins.
Hepatic lobule
central venule (C) bile duct (D) venule (V) arteriole (A)
Hepatocytes
5- to 12-sided polygonal cells,
approximately 20 to 30 m in
diameter, that are closely packed
together to form anastomosing
plates of liver cells, one cell in
thickness.
The surface of each hepatocyte is in

contact with the wall of a sinusoid,
through the perisinusoidal space, and with
the surfaces of other hepatocytes
Where two hepatocytes abut, they delimit

a tubular space between them known as
the bile canaliculus
Hepatic sinusoids
hepatocytes (H)
stellate macrophages (M) Kuppfer cells endothelial cells (E)
sinusoid (S) perisinusoidal space (PS) the space of Disse
fibroblastic fat-storing cells (F) Ito cells
Stellate macrophages (Kupffer cells)
Are found between sinusoidal endothelial cells and on the luminal surface
within the sinusoids, mainly near the portal areas.
Functions :
break down aged erythrocytes and free heme for re-use
remove bacteria or debris that may enter the portal blood from the gut
act as antigen-presenting cells in adaptive immunity.
Stellate fat storing cells (Ito cells)
Are found in the perisinusoidal space (not the lumen) with small lipid
droplets containing vitamin A
Make up about 8% of the cells in a liver, but difficult to see in routine
preparations
Store much of the body's vitamin A
Produce ECM components
Have a regulatory role in local immunity
Medical aplication :
Chronic liver diseases Ito cells proliferate acquire myofibroblasts
damaged hepatocytes development of fibrosis
Bile ductules
cuboidal epithelial cells

Cholangiocytes
Secretion of
bile acids
Concepts of structure-function relationships
in liver
Liver Regeneration
Liver has a strong capacity for regeneration despite its slow rate of cell renewal.
Compensatory hyperplasia
Stem cells called oval cells are present in the initial epithelium of bile ductules
near the portal areas and these can give rise to both hepatocytes and
cholangiocytes.
Medical aplication :
Ethanol, drugs, chemicals, hepatitis virus (mainly types B, C, or D), parasites, and
autoimmune liver disease
continuous or repeated damage to hepatocytes multiplication of liver cells
increase of connective tissue (fibrosis) cirrhosis progressive and irreversible
liver failure
BILIARY TRACT & GALLBLADDER
Hepatocytes produce bile
bile canaliculi, bile ductules, bile ducts.
hepatic duct
+
cystic duct
(from the gallbladder)
continues to the duodenum as the

common bile duct
Medical aplication
Most malignant tumors of the liver derive from hepatocytes or cholangiocytes of
the hepatic ducts.
The pathogenesis of liver carcinoma is associated with a variety of acquired
disorders, such as chronic viral hepatitis (B or C) and cirrhosis.
In the exocrine pancreas, most tumors also arise from duct epithelial cells; the
mortality rate from pancreatic tumors is high.
Gallbladder
is a hollow, pear-shaped organ
attached to the lower surface of
the liver, capable of storing 3050
mL of concentrates bile, and
releases it into the duodenum after
a meal
simple columnar epithelium (arrow)

lamina propria (LP)
muscularis (M)
external adventitia (A
PANCREAS
is a mixed exocrine-
endocrine gland that
produces both
digestive enzymes
and hormones
Pancreas
The digestive enzymes are produced
by cells of the larger exocrine
portion
The hormones are synthesized in
clusters of endocrine epithelial cells
known as pancreatic islets (islets of
Langerhans)
pancreatic islets (I)

serous acini (A)
blood vessels (V)
interlobular ducts (D)
Pancreatic acini
small acini (A) connective tissue with fibroblasts (F)

Pancreatic juice
The exocrine pancreas secretes 1.5 to 2 L of fluid per day Pancreatic juice
Rich in bicarbonate ions (HCO3) and digestive enzymes :
proteases (trypsinogens, chymotrypsinogen, proelastases, protease E, kallikreinogen,
procarboxipeptidases)
-amylase
lipases
nucleases (DNAase and RNAase)
The proteases are stored as inactive zymogens (trypsinogen) in the secretory
granules of acinar cells cleaved and activated by enterokinase in small intestine
Trypsin activate the other proteases in a cascade.
This, along with production of protease inhibitors by the acinar cells, prevents the
pancreas from digesting itself.
Medical Aplication
Acute necrotizing pancreatitis proenzymes may be activated and digest
pancreatic tissues
Extreme malnutrition kwashiorkor pancreatic acinar cells and other

active protein-secreting cells atrophy and lose much of their rough ER,
hindering production of digestive enzymes
Pancreatic islets
Pancreatic islets
or A cells secrete primarily glucagon and are usually

located near the periphery of islets.
or B cells produce insulin are located centrally in islets

and are the most numerous cell type.
or D cells secreting somatostatin, are scattered and

much less abundant.
References

Histologi Hepatobilier Dan Pankreas

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Histology of Hepatobilliary and

The surface of each hepatocyte is in

Where two hepatocytes abut, they delimit

cuboidal epithelial cells

bile canaliculi, bile ductules, bile ducts.

continues to the duodenum as the

simple columnar epithelium (arrow)

pancreatic islets (I)

small acini (A) connective tissue with fibroblasts (F)

Extreme malnutrition kwashiorkor pancreatic acinar cells and other

or A cells secrete primarily glucagon and are usually

or B cells produce insulin are located centrally in islets

or D cells secreting somatostatin, are scattered and

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