Lipomatous pseudohypertrophy of the pancreas with complete absence of exocrine tissue

Høyer, Andreas

doi:10.1002/path.1700610110

Cited by 26 publications

(10 citation statements)

References 6 publications

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“…2,4,6,7,9,10,14–16,26,27 Hoyer 16 discussed the possibility of a congenital anomaly, in view of the incidence in childhood, but thought that the condition was more probably acquired, due to injury of the pancreatic parenchyma by infective or toxic agents.…”

Section: Discussionmentioning

confidence: 99%

Lipomatous Pseudohypertrophy of the Pancreas

Altinel¹,

Basturk²,

Sarmiento³

et al. 2010

Pancreas

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Objectives Owing to the challenges in obtaining pancreatic biopsies, pancreatic resection for presumed malignancy is often performed without histological confirmation. As a result, benign lesions are sometimes surgically removed. One such condition, which is poorly defined in the literature, is referred to as lipomatous pseudohypertrophy (LPH) of the pancreas. Methods Five cases of LPH were analyzed. Results Four patients underwent surgical resection, 3 of which were diagnosed preoperatively by radiology as having ductal adenocarcinoma. The fourth case was correctly interpreted by magnetic resonance imaging as LPH, but the patient underwent resection because of the intractable pain due to pancreatitis. The fifth patient has been placed on watchful waiting. Two tumors were in the pancreatic head, one in the tail, one in the uncinate process, and one demonstrated diffuse involvement. Microscopically, they were characterized as having normal lipocytes without lipoblasts or inflammation. Within the adipose tissue, scattered microscopic foci of pancreatic parenchyma could be seen. Conclusion Lipomatous pseudohypertrophy of the pancreas is a distinct entity characterized by localized/diffuse replacement of pancreatic parenchyma with mature adipose tissue. It forms a pseudotumor that may be difficult to distinguish clinically from pancreatic adenocarcinoma. This entity should be considered when evaluating patients with a new diagnosis of a hypodense pancreatic neoplasm on imaging.

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Section: Discussionmentioning

confidence: 99%

Lipomatous Pseudohypertrophy of the Pancreas

Altinel¹,

Basturk²,

Sarmiento³

et al. 2010

Pancreas

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“…A literature search of Japana Centra Revuo Medicina and PubMed revealed only 27 other cases worldwide, including those in which the condition was diagnosed with imaging alone [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Unlike steatosis resulting from obstruction of the pancreatic duct by pancreatolithiasis or a tumor, the causal factors of this disease are unknown.…”

Section: Discussionmentioning

confidence: 99%

“…LiPH of the pancreas is an extremely rare disease that is defined by (1) the enlargement and increased weight of the pancreas and morphological uniformity of the pancreas, (2) complete replacement of the pancreatic exocrine tissue by fatty tissue, and (3) sparing of the pancreatic duct system and islets of Langerhans [ 1 ]. A literature search of Japana Centra Revuo Medicina and PubMed revealed only 27 other cases worldwide, including those in which the condition was diagnosed with imaging alone [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Unlike steatosis resulting from obstruction of the pancreatic duct by pancreatolithiasis or a tumor, the causal factors of this disease are unknown.…”

Section: Discussionmentioning

confidence: 99%

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Lipomatous Pseudohypertrophy of the Pancreas Taking the Form of Huge Massive Lesion of the Pancreatic Head

Shimada¹,

Shibahara²,

Kitamura³

et al. 2010

Case Rep Gastroenterol

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A 70-year-old woman presented with hypogastric pain. Computed tomography and magnetic resonance imaging revealed a retroperitoneal tumor 18.0 cm in diameter with fatty tissue density, ventrally compressing the pancreatic head. We suspected a well-differentiated liposarcoma compressing the pancreas. At laparotomy, the tumor mass was the size of an infant’s head; its center was located in the area corresponding to the pancreatic uncus. It was continuous with the pancreatic parenchyma through a poorly demarcated border, and we resected as much of the tumor mass as possible while conserving the pancreatic capsule. Histopathological examination indicated lipomatous pseudohypertrophy of the pancreas with proliferation of mature fatty tissue as the main constituent. At the periphery, islands of acinar tissue were retained among the fatty infiltration, which also contained branches of the pancreatic duct and islets of Langerhans. Previous reports have stated that this disorder only causes fatty replacements throughout the pancreas or in the pancreatic body and tail; however, in this patient, imaging and macroscopic examination revealed no fatty replacements in the pancreatic body and tail. We report this case, which we consider extremely rare, along with a brief review of the literature.

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“…Monoamines, especially adrenaline and noradrenaline, are well known to play an important role in fat catabolism. In this connection, it was of considerable interest that the present case was associated with lipomatous pseudohypertrophy (diffuse fat replacement) of the pancreas (2)(3)(4)(5)(6)(7)(8), despite the patient's general emaciation. This discrepancy has often been seen in reported cases of lipomatous pseudohypertrophy of the pancreas ( Table 1).…”

Section: *Aspiration Pneumoniamentioning

confidence: 93%

Diffuse Mallory Bodies in the Liver, Diffuse Lewy Bodies in the Brain and Diffuse Fat Replacement (Lipomatous Pseudohypertrophy) of the Pancreas in a Patient with Juvenile Parkinson's Disease

Yoshimura

Hayashi

Fukushima

1992

Acta Pathologica Japonica

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A 38‐year‐old male patient with the juvenile variant of Parkinson's disease, in whom onset had occurred at the age of 24 yr, was autopsied. There were no clear symptoms of pancreatic or hepatic insufficiency during the entire clinical course. The only notable features were a slightly delayed decrease of the blood glucose level in an oral glucose tolerance test, slightly elevated levels of serum alkaline phosphatase and serum lactate dehydrogenase, and episodic loose stools. Autopsy revealed uniform enlargement of the pancreas due to massive fat replacement (lipomatous pseudohypertrophy): the exocrine glandular elements showed marked atrophy and loss, while the islets of Langerhans were preserved. The liver exhibited a histology closely mimicking alcoholic hepatitis associated with the diffuse presence of Mallory bodies (MBs), possibly indicative of a disturbance of protein metabolism. The nervous system showed the diffuse presence of Lewy bodies (LBs) in the cerebrum in addition to the ordinary lesions of Parkinson's disease. Although the etiopathogenesis of none of these three lesions has been well elucidated, common epitopes of MBs and LBs have recently been demonskated. Therefore, the present case study suggests that a specific underlying toxic agent may cause diffuse LBs in the brain on the one hand, and diffuse MBs in the liver and lipomatous pseudohypertrophy of the pancreas on the other. Acta Pathol Jpn 42: 826–831, 1992.

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Lipomatous pseudohypertrophy of the pancreas with complete absence of exocrine tissue

Cited by 26 publications

References 6 publications

Lipomatous Pseudohypertrophy of the Pancreas

Lipomatous Pseudohypertrophy of the Pancreas

Lipomatous Pseudohypertrophy of the Pancreas Taking the Form of Huge Massive Lesion of the Pancreatic Head

Diffuse Mallory Bodies in the Liver, Diffuse Lewy Bodies in the Brain and Diffuse Fat Replacement (Lipomatous Pseudohypertrophy) of the Pancreas in a Patient with Juvenile Parkinson's Disease

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