title: Longterm follow-up of small pancreatic cystic lesions in liver transplant recipients.
abstract: Incidental small pancreatic cystic lesions (PCLs) are often found on preoperative imaging in patients undergoing orthotopic liver transplantation (OLT). Although these are considered benign or of low malignant potential, the influence of immunosuppression after OLT may be of concern. The aim of this study was to observe the longterm outcome of these small PCLs in post-OLT patients. An institutional OLT database of 1778 consecutive OLT patients from January 2000 to December 2010 was analyzed. Computed tomography, magnetic resonance imaging, or endoscopic ultrasound at the time of OLT and all subsequent imaging, cytology, fluid analysis of PCLs, and patient status were evaluated. A total of 70 patients with 182 PCLs, of benign or low malignant potential, were identified with a mean follow-up time of 64 months. At initial diagnosis of PCLs in 48 patients, 7 branch duct-type intraductal papillary mucinous neoplasms (B-IPMNs), 1 serous cystadenoma (SCA), and 40 nonspecific benign cysts were identified. Final diagnosis at the end of the follow-up revealed 16 B-IPMNs, 3 SCAs, and a mixed acinar-neuroendocrine carcinoma, in which the latter developed 9 years after initial diagnosis of B-IPMN. During the follow-up time, average increase in size and number of PCLs were 4.5 mm and 1.4, respectively (P < 0.001 for both). The majority of incidental PCLs in OLT patients showed an indolent behavior despite immunosuppression. Risk of malignancy development was very low and comparable with normal population. Liver Transplantation 23 324-329 2017 AASLD.
authors.affiliation: Department of Radiology, University of California, Los Angeles, CA.|Department of Radiology, Chulabhorn Hospital, Bangkok, Thailand.
authors.forename: Sirachat
authors.initials: S
authors.lastname: Vidhyarkorn
authors.affiliation: Department of Radiology, Chulabhorn Hospital, Bangkok, Thailand.
authors.forename: Surachate
authors.initials: S
authors.lastname: Siripongsakun
authors.affiliation: Department of Radiology, University of California, Los Angeles, CA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yu
authors.affiliation: School of Public Health, University of California, Los Angeles, CA.
authors.forename: James
authors.initials: J
authors.lastname: Sayre
authors.affiliation: Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA.
authors.forename: Vatche G
authors.initials: VG
authors.lastname: Agopian
authors.affiliation: Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Durazo
authors.affiliation: Department of Radiology, University of California, Los Angeles, CA.
authors.forename: David S
authors.initials: DS
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging* / Q000453:epidemiology; D049448:Cholangiopancreatography, Magnetic Resonance; D018293:Cystadenoma, Serous / Q000000981:diagnostic imaging* / Q000453:epidemiology; D058625:End Stage Liver Disease / Q000601:surgery*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D015994:Incidence; D033162:Incidental Findings; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging* / Q000453:epidemiology; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods; D014057:Tomography, X-Ray Computed; D066027:Transplant Recipients