Department of Pathology, Emory University, Atlanta, GA 30322, USA.
Pancreas. 2010 Apr;39(3):392-7. doi: 10.1097/MPA.0b013e3181bd2923.
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.
Five cases of LPH were analyzed.
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.
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.
由于获取胰腺活检存在困难，因此常对疑似恶性肿瘤的胰腺进行切除术，而无需组织学确认。结果，有时会切除良性病变。其中一种情况在文献中定义不明确，被称为胰腺脂肪假肥大（LPH）。
分析了 5 例 LPH。
4 例患者接受了手术切除，其中 3 例术前影像学诊断为导管腺癌。第 4 例通过磁共振成像正确解释为 LPH，但由于胰腺炎引起的难治性疼痛而进行了切除。第 5 例患者处于观察等待中。2 个肿瘤位于胰头部，1 个位于胰尾部，1 个位于钩突部，1 个呈弥漫性受累。显微镜下，它们的特征是正常的脂肪细胞，没有脂肪母细胞或炎症。在脂肪组织中，可以看到散在的胰腺实质的微小灶。
胰腺脂肪假肥大是一种明确的实体，其特征是局部/弥漫性的胰腺实质被成熟脂肪组织取代。它形成一种假性肿瘤，临床上可能难以与胰腺腺癌区分。在评估影像学上新诊断的低密度胰腺肿瘤患者时，应考虑到这种实体。
