Synonyms
Definition
Metaplastic change of group of acini into tubular structures characterized by dilation, lumen formation, and usually flattened epithelial lining.
Clinical Features
Incidence
ADM is frequently observed in pancreatic resection specimens with chronic pancreatitis and pancreatic neoplasms. In a study consisting of 92 resection specimens with pancreatic cancer, 45 with non-autoimmune chronic pancreatitis and 27 with serous cystic neoplasms, ADM was observed in 78%, 83%, and 67%, respectively (Esposito et al. 2007). Another study reported a frequency of 30% in chronic pancreatitis specimens (Cylwik et al. 1998). An accurate postmortem study on 100 consecutive autopsies (male veterans, age 35–88) revealed a frequency of 21% of “ductular hyperplasia grade 1,” which corresponds to ADM according to the illustrations provided in the paper (Pour et al. 1982).
Age
Due to its concomitance with inflammatory and neoplastic diseases of the pancreas, ADM is...
References and Further Reading
Aichler, M., Seiler, C., Tost, M., Siveke, J., Mazur, P. K., Da Silva-Buttkus, P., et al. (2012). Origin of pancreatic ductal adenocarcinoma from atypical flat lesions: A comparative study in transgenic mice and human tissues. Journal of Pathology, 226(5), 723–734. https://doi.org/10.1002/path.3017.
Cylwik, B., Nowak, H. F., Puchalski, Z., & Barczyk, J. (1998). Epithelial anomalies in chronic pancreatitis as a risk factor of pancreatic cancer. Hepato-Gastroenterology, 45(20), 528–532.
Esposito, I., Seiler, C., Bergmann, F., Kleeff, J., Friess, H., & Schirmacher, P. (2007). Hypothetical progression model of pancreatic cancer with origin in the centroacinar-acinar compartment. Pancreas, 35(3), 212–217. https://doi.org/10.1097/mpa.0b013e31805d0190.
Hruban, R. H., Maitra, A., & Goggins, M. (2008). Update on pancreatic intraepithelial neoplasia. International Journal of Clinical and Experimental Pathology, 1(4), 306–316.
Matsuda, Y. (2019). Age-related morphological changes in the pancreas and their association with pancreatic carcinogenesis. Pathology International, 69(8), 450–462. https://doi.org/10.1111/pin.12837.
Pour, P. M., Sayed, S., & Sayed, G. (1982). Hyperplastic, preneoplastic and neoplastic lesions found in 83 human pancreases. American Journal of Clinical Pathology, 77(2), 137–152. https://doi.org/10.1093/ajcp/77.2.137.
von Figura, G., Fahrenkrog-Petersen, L., Hidalgo-Sastre, A., Hartmann, D., Huser, N., Schmid, R. M., et al. (2017). Atypical flat lesions derive from pancreatic acinar cells. Pancreatology, 17(3), 350–353. https://doi.org/10.1016/j.pan.2017.04.014.
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Esposito, I., Haeberle, L. (2021). Acinar: Ductal Metaplasia. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5522-1
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DOI: https://doi.org/10.1007/978-3-319-28845-1_5522-1
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