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膵がんの早期発見の所見として、膵管拡張と各種がん抑制遺伝子の機能不全のパタｰンから、そもそも何故膵管拡張なのか、なぜ委縮なのか、なぜ癌化するのかをまずは血流不全と酸化ストレス、線維化、慢性炎症の観点から論文検索中です

 Because SPNs are of low-malignancy, they rarely obstruct the main pancreatic duct (MPD) and cause atrophy of the distal pancreas even if their tumor sizes are large

Distal pancreatectomy and splenectomy were performed because of elevated carcinoembryonic antigen levels, atypical cells on biopsy, and an increase in cyst size. Owing to the benign nature of this case, postresection surveillance was not necessary.

a close-to-normal pancreas with minimal fat deposition or atrophy is thought to indicate a higher risk of postoperative pancreatic fistulas after distal pancreatectomy.

 Video-assisted thoracoscopic esophagectomy and distal pancreatectomy were performed. Histological examination of the resected pancreas revealed abundant abnormal vessels with intravascular thrombi. In addition, rupture of a dilated pancreatic duct with pancreatic stones and both severe atrophy and fibrosis of the pancreatic parenchyma were observed. The final diagnoses were P-AVM consequent to severe chronic pancreatitis and esophageal carcinoma.

While the prognosis of advanced pancreatic neck adenocarcinoma is still dismal, extended distal pancreatectomy is a valid treatment option, especially when there is atrophy of the distal pancreas. Also, the procedure is technically feasible, and further refinement is necessary to improve patient survival.

Slow-growing tumors resulted in obstructive pancreatitis of the distal pancreas and insufficient focal blood flow, resulting in marked atrophy of the pancreas and fatty replacement. 

The 2012 guidelines for the management of IPMN recommend that patients with 'high-risk stigmata' (obstructive jaundice, enhanced solid component, and main pancreatic duct size ≥10 mm) should undergo resection. Patients with 'worrisome features' (cyst size ≥3 cm, thickened enhanced cyst walls, non-enhanced mural nodules, main pancreatic duct size 5-9 mm, abrupt change in main pancreatic duct caliber with distal pancreatic atrophy, lymphadenopathy, and clinical acute pancreatitis) should be evaluated by EUS. EUS is a more sensitive test than computed tomography or magnetic resonance imaging for the early detection of malignancy.