Association Between Pancreatic Cystic Lesions and High-grade Intraepithelial Neoplasia and Aging: An Autopsy Study

Pancreas. 2019 Sep;48(8):1079-1085. doi: 10.1097/MPA.0000000000001374.

Abstract

Objectives: This study aimed to clarify clinicopathological features of pancreatic cysts.

Methods: Pancreata from 280 autopsies (median, 83 years; male, 146; female, 134) were sectioned every 5 mm. Cysts (<10 mm) were diagnosed as a simple cyst or low-grade, intermediate-grade, or high-grade dysplasia.

Results: We found 236 cysts in 93 patients (33.2%). The number and diameter of cysts increased according to the age. Of the 236 cysts, 9 (3.8%) were with high-grade dysplasia. Cysts with high-grade dysplasia arose in the pancreata of older patients with larger numbers of cysts. In contrast, 15 noncystic lesions with high-grade dysplasia were also detected. Hence, in total, 24 high-grade dysplastic lesions in 15 patients (5.4%) were noted. Of the 15 patients with high-grade dysplastic lesions, in 10 patients, the condition was accompanied by pancreatic cysts, whereas 5 patients did not have any cysts in the pancreas; therefore, patients with cyst showed higher incidence of high-grade dysplasia (10.8%; P = 0.0047) than patients without cyst (2.7%). All cysts with high-grade dysplasia were located in the branch duct of the pancreatic head/body, whereas 20% of noncystic lesions with high-grade dysplasia were located in the main pancreatic duct.

Conclusions: Cystic lesions with high-grade dysplasia may have different characteristics compared with noncystic high-grade dysplasia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging*
  • Autopsy / methods*
  • Body Mass Index
  • Carcinoma in Situ / pathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Pancreatic Cyst / pathology*
  • Pancreatic Ducts / pathology*
  • Pancreatic Neoplasms / pathology*