The relationship of cystic lesions of the acini of the pancreas to age, cause of death, and fibrocystic disease in children.

Dilated plugged acini in the pancreas are one of the fundamental histological features in 'fibrocystic disease.' Andersen (1938), however, in her original article on 'Fibrocystic Disease in the Pancreas in Relation to Celiac Syndrome' pointed out that cystic acini occur in a large number of children, and she was careful to confine her diagnosis of fibrocystic disease to cases where more than 90% of the acini of the gland were affected. Following Andersen's work there has been an increased interest in the presence of cystic changes in the acini of the pancreas, and lesions have been described in a number of apparently quite different conditions. Baggenstoss (1947, 1948a and b) described a high incidence of plugged acini in chronic nephritis, hypertension, uraemia, ulcerative colitis, and intestinal obstruction; Mallory (1947) in severe infections and in all of 24 cases of typhus; Gillman and Gillman (1945) found the lesion in malnutrition in South Africa; Wallace and Ashworth (1942) and Andrew (1944) in old age; and Hartz (1948) in patients dying after starvation. Relatively little interest appears to have been taken in the significance of these plugged acini in children not showing the full fibrocystic syndrome. An attempt has been made here to determine the incidence of plugged and cystic acini in the pancreas of children at necropsy, and to relate these lesions to the clinical disease and age of the children.