title: Evolution of pancreas in aging: degenerative variation or early changes of disease?
abstract: Pancreatic changes in aging have been described for many decades. They involve not only pancreatic parenchyma but also pancreatic ductal, microscopic, and exocrine functional changes. There have been many studies of these changes based on pathology and various imaging modalities, as well as functional studies. The pancreatic volume was found to decrease with advancing age, with a higher incidence of pancreatic steatosis, as demonstrated in autopsy and imaging studies. The pancreatic ductal structure has been described with wide ranges of normal variation, but many studies have shown a tendency toward enlargement with advancing age. By endoscopic ultrasound imaging, the aging pancreas may exhibit abnormal findings similar to chronic pancreatitis. Microscopically, there has been evidence of patchy lobular fibrosis and papillary hyperplasia and demonstrable k-ras mutation in both normal and dysplastic ductal mucosa. The evidence of pancreatic exocrine insufficiency has yielded conflicting results, but most studies have shown a tendency toward decreased pancreatic exocrine function in the elderly. Differentiating pancreatic change in the elderly from early chronic pancreatitis may be difficult as there are limited studies to compare these two conditions in terms of structural and functional changes.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Tanyaporn
authors.initials: T
authors.lastname: Chantarojanasiri
authors.affiliation: Department of Endoscopy, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya City, 466-8550, Japan. hirooka@med.nagoya-u.ac.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hirooka
authors.affiliation: Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
authors.forename: Thawee
authors.initials: T
authors.lastname: Ratanachu-Ek
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kawashima
authors.affiliation: Department of Endoscopy, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya City, 466-8550, Japan.
authors.forename: Eizaburo
authors.initials: E
authors.lastname: Ohno
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.|Department of Endoscopy, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya City, 466-8550, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
mesh_terms: D000375:Aging / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D014463:Ultrasonography
keywords: Age-related change; Pancreas