Complete pancreatic lipomatosis

Pancreatic Steatosis Is Associated with Both Metabolic Syndrome and Pancreatic Stiffness Detected by Ultrasound Elastography

INTRODUCTION

There is increasing evidence that pancreatic steatosis (PS) is associated with metabolic syndrome (MS). However, it is not known whether it is associated with PS grade and pancreatic stiffness, or not. We aimed to evaluate the relationship between PS and its grade detected by transabdominal ultrasound, and pancreatic stiffness determined by two-dimensional shearwave elastography (2D-SWE), whether it has clinical significance and its relationship with MS.

METHODS

Patients with and without PS were evaluated prospectively.

RESULTS

Patients with PS had higher odds ratio for MS (OR 5.49). Also, ultrasonographic grade of PS was associated with MS parameters and hepatosteatosis. Pancreatic SWE value was significantly higher in PS group and positively correlated with PS grade, liver fat, MS, number of MS criteria.

DISCUSSION/CONCLUSION

PS and its grade were associated with MS. In this first comprehensive PS-SWE study, we found that pancreas stiffness increased in the presence of PS, in correlation with PS grade and MS.

Extensive Fatty Replacement of the Pancreas (Pancreatic Lipomatosis) in a Dog

A 12-year-old neutered female mixed-breed dog was referred for occasional vomiting that had increased progressively in frequency over the past 3 months. Palpation of the abdomen revealed a firm mass of unknown aetiology, located within the cranial to mid abdomen, while abdominal surgical exploration revealed a well-defined abdominal mass of pancreatic origin. The pancreatic mass caused lateral displacement of the duodenum as well as medial displacement of the pylorus, resulting in impairment of pyloric outflow. Further examination revealed a firm, poorly vascularized and coarsely lobulated structure. The histopathological findings were consistent with severe pancreatic lipomatosis and atrophy. Immunohistochemically, the remnant pancreatic cells were positive for cytokeratins AE1/AE3 and glucagon, and negative for insulin. Routine follow-up with the referring veterinarian showed no evidence of postoperative complications, but the dog continued to deteriorate further and died despite medical management. Pancreatic lipomatosis is a rare condition in small animal practice. The aetiology or predisposing factors have not been identified in animals.

Effects of aging and menopause on pancreatic fat fraction in healthy women population: A strobe-compliant article

Pancreatic fat fraction has been shown to increase in many pathological situations. However, pancreatic fat fraction and its physiological changes in healthy women are still unclear. The aim of this study is to investigate the effect of aging and menopause on pancreatic fat fraction in healthy female population.This was a cross-sectional study. A phantom of fat-water mixtures was established. One hundred sixty-seven healthy women (20-70 years) were recruited. Fat fraction was quantified with double-echo chemical shift magnetic resonance imaging with T1 and T2* correction. The association between measured and actual fat fractions was determined with Pearson correlation. Linear regression analysis was used to establish the calibration curve. Fat fractions were analyzed via analysis of variance.A significant positive linear correlation was revealed between the measured and actual fat fractions on the phantom (r = 0.991, P < .001). There was no significant difference in fat fractions among caput, corpus, and cauda of the pancreas. Pancreatic fat fraction remained constant during the age of 20 to 40 years (4.41 ± 0.79%) but significantly increased during the ages of 41 to 50 and 51 to 70 years (7.49 ± 1.10% and 9.43 ± 1.51%, respectively, P < .001). Moreover, pancreatic fat fractions of the healthy women aged 41 to 70 years were still significantly higher than these in the groups aged 20 to 40 years when postmenopausal healthy women were removed (P < .001). For volunteers aged 46 to 49 years, pancreatic fat fraction of the postmenopausal women was significantly increased compared with that of their premenopausal counterparts (P < .001).We found that an even distribution of pancreatic fat in healthy women, aging and menopause as 2 independent risk factors for pancreatic steatosis, a fatty infiltration in the pancreas beginning in the fifth decade in women.