Extensive Fatty Replacement of the Pancreas: Its Clinicoptahological Features
M Shimizu, H Yamaguchi, K Nagata, L Jin, S Sannohe, T Ichimura, T Sakurai, Y Shimizu, A Sasaki, S Murata, M Yasuda. Saitama Medical University, Saitama International Medical Center, Hidaka City, Saitama, Japan
Background: Fatty replacement is also known as lipomatosis, which results from a partial replacement of the acini by fatty tissue, without any significant inflammation or scarring. When it shows a significant replacement of the exocrine elements by adipose tissue, it may be called “lipomatous psuedohypertrophy.” However, these lipomatous lesions are not fully described in the literature.
Design: In this study, we use the term “extensive fatty replacement.” Here, we defined extensive fatty replacement of the pancreas as an entity in which “macroscopically at least two of the three segments (pancreatic head, body, and tail) are replaced by fatty tissue, and microscopically more than 50% of the section is replaced by fatty tissue”. We reviewed eight cases of extensive fatty replacement of the pancreas, including one surgical case and seven autopsy cases. We investigated the clinicopathological features of these cases.
Results: The average age of the patients studied ranged 49 to 89 years, and most cases were female. Three cases had a pancreatic mass in the head, and obstructive jaundice was noted. Another four cases revealed diabetes mellitus. One case showed alcoholic liver cirrhosis. In all cases, the pancreatic duct either had disappeared or was obstructed. Most cases revealed fatty replacement of the pancreatic body and tail. Microscopically, mature adipose tissue replaced the acini and most of the ducts. The islets were mostly preserved, but parts of the acini and ducts were also preserved. Arteriosclerosis was noted in half of the cases. There was no significant inflammatory infiltrate, nor was there any scar formation.
Conclusions: Extensive fatty replacement of the pancreas is predominantly found in females with an average age of 70. It is also associated with diabetes mellitus as well as pancreatic head tumors. Entrapped islets within the fatty tissue are a histopathological clue to rule out congenital defect of pancreatic body and tail.
Category: Liver & Pancreas
Tuesday, March 23, 2010 1:00 PM
Poster Session IV # 199, Tuesday Afternoon