The substance in the acini is a mucoprotein that does not stain for mucopolysaccharides. The acid mucopolysaccharides are located in the large-sized ducts, and as the cysts increase in size and acinar cell atrophy is found, the acid mucopolysaccharides collect. In contrast, the goblet cells undergo papillary hyperplasia and become conspicuous. The fat and fibrous tissue replace the glandular tissue that undergoes atrophy. The pancreas in cystic fibrosis cases has the proliferation of the cento-acinar, and intercalary ductular cells result in necrosis that leaves detritus that cause the inspissation the ducts and aciniâ€”the ductular occlusion results in pressure atrophy of the acinar epithelium. Pancreatic insufficiency is linked with abnormal absorption of fats and protein and increases fecal loss. A manifestation of abnormal absorption appears during the first year of life. The abnormal absorption of fat includes the lack of fat-soluble vitamins, which results in avitaminosis A, D, or K. Idiopathic chronic pancreatitis occurs in the person having pancreas-sufficient cystic fibrosis and is linked with abdominal pain, which becomes chronic.
The shape, color, and size of the pancreas are usually normal, but it is abnormally small in some cases. The lobules are spherical rather than diamond shape and fused by the fibrous tissue. The lumen in the fibrous tissue extends between 5 to 15mm from the ampulla of Vater.
The head of the pancreas tends to be dilated and consists of yellow or white plugs recognized with the naked eyes in some cases. Cystic fibrosis in the pancreas is flattened, resulting in a thin epithelial wall in the acinar cells. The normal cells surround the smaller concretions, which occasionally contain eosinophilic granules. The small duct contains substances similar to that in the acini. The fusions are less or more deeply eosinophilic; the larger ducts are laminated with eosinophilic central substances enclosed by a paler material, while the smaller ducts are homogenous. There may be few phagocytes or rare polymorphonuclear leucocyte, in the cysts, consisting of the paler substance, desquamated epithelial cells.
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