| Discussion: |
While these findings of diffuse fatty replacement of the pancreas raise the suspicion of CF, the patients medical history was relatively benign and given the patients somewhat advanced age it is highly unlikely that this represents CF. Rather, this is simply fatty change or lipomatous pseudotumor of the pancreas.
The patient was referred for testing for cystic fibrosis however, which was negative.
Uniform fatty replacement of the exocrine pancreas is the most frequent CT finding in adolescent and adult patients with CF. Although this change tends to occur more often in older patients and represents a late phenomenon, it can also be found earlier in the course of the disease. In the most advanced stages of CF, the exocrine tissue of the pancreas is replaced by fat.
In microscopic terms, the parenchyma consists of mature adipose tissue separated by fibrous septa and contains isolated clusters of islets of Langerhans. Typically, no residual exocrine tissue are evident except for a few remaining pancreatic ductules.