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First page of Focal pancreatic parenchymal atrophy: An alternative indicator for early-stage pancreatic cancer

Background: Pancreatic ductal adenocarcinoma (PDAC) is characterized by a poor prognosis, with a high mortality rate often attributed to its late-stage diagnosis. Early detection remains paramount in improving survival outcomes for affected individuals. Summary: The prognosis of PDAC can be significantly improved if the cancer is diagnosed at an early stage, specifically when it remains localized to the ductal epithelium. This early stage is commonly referred to as high-grade pancreatic intraepithelial neoplasia (HG-PanIN) or carcinoma in situ (CIS, stage 0). At this stage, metastasis has not yet occurred, offering the potential for more effective therapeutic interventions. Focal pancreatic parenchymal atrophy (FPPA) has emerged as a crucial radiological and pathological feature suggestive of HG-PanIN/CIS. Key Message: Accurate identification of FPPA is critical for diagnosing HG-PanIN and CIS, both of which represent pre-invasive stages of PDAC. Given the implications of early detection, serial pancreatic juice cytologic examination is recommended for patients exhibiting FPPA to facilitate timely diagnosis and intervention.

Journal Section:
Review Article
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S. Karger AG, Basel
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2025
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