Morphology and pathological significance of focal acinar cell dysplasia of the human pancreas

Abstract

Focal acinar cell dysplasia (FACD) was studied in 138 autopsied pancreases by multiple transsection examination and was found in 13 of the pancreases (9.4%). The average number of FACD per pancreas identified in our study was 5.7, ranging from 1 to 20, and the total number was 60. The location of FACD was 22 in head, 18 in body, and 20 in tail of the pancreas. FACD were rare lesions and found in only 41 of 2,819 slides (1.5%). The incidence of FACD seemed to be higher among males than among females, among patients with cancer in other sites than among those with no cancer, among diabetics than among nondiabetics, among heavy smokers than among nonsmokers, and among alcohol abusers than among abstainers. The males and heavy smokers had significantly more nodules of FACD per pancreas than females and nonsmokers. Simple and atypical hyperplasia of pancreatic ducts were found in 119 (86.2%) and 18 (13.0%), respectively. All pancreases with FACD had simple ductal hyperplasia. FACD and atypical ductal hyperplasia coexisted in one patient who had a history of heavy smoking, and this patient had the most nodules of FACD per pancreas among patients with FACD. No FACD was observed in pancreases without ductal hyperplasia. These findings suggested heavy cigarette smoking was one of the possible causes of FACD and ductal hyperplasia of pancreas.