Retrospective Histopathological Study of Pancreatic Fibrosis in Cadaver Samples

Abstract

Background: Pancreatic fibrosis has also been found to occur in association with insulin insufficiency and pancreatic ductal adenocarcinoma. It is important to investigate the development, progression and causal factors of fibrosis.

Methods: We examined pancreatic fibrosis in 53 postmortem specimens from cadavers without any known pancreatic disease (mean age: 86.6 years; range, 58-104 years), as well as related types of fibrosis and other lesions found in these specimens. Fibrosis was classified as intralobular and interlobular fibrosis, each type of fibrosis was scaled as mild, moderate and marked.

Results: Intralobular fibrosis was seen in 51 of 53 (96.2%) cases (mild, 52.9%; moderate, 28.3%; marked, 15.1%). Interlobular fibrosis was seen in 22 of 53 (41.5%) cases (mild, 20.8%; moderate, 17.0%; marked, 3.8%]. Pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN), along with other lesions, islet cells loss, and inflammatory cell infiltration were also found in our study. A dependent relationship was found between intralobular fibrosis and interlobular fibrosis, and between intralobular fibrosis and PanIN, IPMN. A higher incidence of interlobular fibrosis was found at the body and tail region of the pancreas, in comparison to the head region.

Conclusion: These findings suggested that pancreatic duct obstruction may be an important factor causing fibrosis in this study, and also suggest that some undocumented factors may underlie the formation of fibrosis. Thus, further studies may need to explore uncovered factors to elucidate the reasons the high prevalence of fibrosis among the elderly.

Note:
Funding Information: Part of this study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Nos. 25460265 and 19K07271).

Conflict of Interests: None of the authors has any conflicts of interest to declare

Ethical Approval: All study procedures were approved by The Study Security Ethics Committee of Tokyo Metropolitan University (No.18051) and The Nippon Dental University Tokyo (NDU-T- 2016-29), and this study was performed in accordance with institutional guidelines.

Keywords: Pancreatic fibrosis, Pancreatic intraepithelial neoplasia, Intraductal papillary mucinous neoplasm, Cadaver