An Autopsy Case of a 5-Year-Old Child with Acute Pancreatitis Caused by Eosinophilic Granulomatosis with Polyangiitis-like Necrotizing Vasculitis

Figure 2

(a) Gross appearance of the pancreas. (b) Gross view of all sections of the pancreas. The arrows indicate hemorrhage spreading from the pancreatic body and tail to the retroperitoneal adipose tissue. (c) Gross view of a section of the pancreatic body. The arrow and arrowheads indicate the hemorrhage and fat necrosis, respectively. (d) Hematoxylin and eosin- (H&E-) stained figure of acute pancreatitis (×100). The arrow indicates necrotizing vasculitis of a small-sized artery. (e) H&E-stained figure of necrotizing vasculitis of a small-sized artery (×100). (f) Higher magnification (×400) of the adventitia of the small artery seen in subfigure (e). Infiltration by numerous eosinophilic cells is observed. (g) Elastica van Gieson-stained figure of a small-sized artery (×100). The arrowhead indicates the internal elastic lamina. The internal elastic lamina disappears in the upper part of the small-sized artery. (h) Masson’s trichrome-stained figure of the small-sized artery (×100). Fibrinoid necrosis is accentuated by the red staining of Masson’s trichrome stain. (i) Immunohistochemical staining indicates that the numerous infiltrating cells around the small-sized artery are CD163-positive histiocytes (×200). H and T in (subfigures a and b) indicate the head and tail of the pancreas, respectively. A: artery. Scale bars = 100 μm (d, e, g, and h), 20 μm (f), and 50 μm (i).