title: Prevalence and outcomes of cystic lesion of the pancreas in immunosuppressed patients with solid organ transplantation.
abstract: BACKGROUND
  Solid organ transplant recipients have an increased risk of cancer due to immunosuppressive therapy. Pancreatic cystic lesions are increasingly being detected, some with malignant potential. We aimed to determine the prevalence of these lesions and describe their clinical course in these patients.
  
  
  METHODS
  We identified the presence of pancreatic cystic lesions in a retrospective cohort of 3188 consecutive solid organ transplant recipients from 2000 to 2013 and compared lesion characteristics at initial and follow-up imaging, when available.
  
  
  RESULTS
  Lesion prevalence was 11.4% (365/3188), and increased with age. Median diameter of the largest lesions was 7mm (range: 1-31mm). We noted worrisome features in two patients (0.54%) at the time of cyst diagnosis. Of 155 patients who underwent follow-up imaging, the cysts size remained stable in 80%, increased in 16%, and decreased in 4%. Two patients (1.3%) developed features concerning for cancer. One underwent pancreatic surgery, and pathology confirmed the presence of high-grade dysplasia. The other continued with conservative management due to multiple comorbidities.
  
  
  CONCLUSIONS
  Pancreatic cystic lesions are common in solid organ transplant recipients. In lesions without high-risk features, the development of features worrisome for cancer is rare. These lesions can be managed conservatively, and their presence should not affect transplant eligibility.
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors: Saowanee
authors: S
authors: Ngamruengphong
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, United States.
authors: Kristina M
authors: KM
authors: Seeger
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, United States.
authors: Luke M
authors: LM
authors: McCrone
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States.
authors: Maria
authors: M
authors: Moris
authors: Department of Radiology, Mayo Clinic, Jacksonville, FL, United States.
authors: Stephen J
authors: SJ
authors: Garrison
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States; Department of Transplant, Mayo Clinic, Jacksonville, FL, United States.
authors: Surakit
authors: S
authors: Pungpapong
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States; Department of Transplant, Mayo Clinic, Jacksonville, FL, United States.
authors: Andrew P
authors: AP
authors: Keaveny
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States. Electronic address: raimondo.massimo@mayo.edu.
authors: Massimo
authors: M
authors: Raimondo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D010179:Pancreas / Q000473:pathology*; D010181:Pancreatic Cyst / Q000175:diagnosis / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Immunosuppressive therapy; Organ transplantation; Pancreatic cystic neoplasms