Relationship of age to prevalence of focal acinar cell dysplasia in the human pancreas.

The prevalence of focal dysplastic lesions of acinar cells in the pancreata of autopsied children and adults was compared. The lesions were recognized in sections stained with hematoxylin and eosin because acinar cells forming islet-sized foci or larger nodules contained one or more of the following cytologic abnormalities: reduced cytoplasmic basophilia, reduced cytoplasm, reduced zymogen, cytoplasmic vacuoles, or nuclear abnormalities. Lesions were found in only 1 patient (age, 7 yr) of 170 patients whose ages ranged from birth to 9 years, whereas 7 of 49 patients 10-19 years old had focal acinar cell dysplasia. The prevalence of such lesions among adults was comparable to that encountered in individuals during the second decade of life and distinctly higher than that found among children during the first decade. Six of the 8 children in whom dysplastic acinar cell foci were found had cancers in other tissues that had been treated by chemotherapy. The data are consistent with the interpretation that dysplastic acinar cell lesions in the pancreas are acquired.