PANCREATIC FIBROSIS IN PATIENTS WITH CHRONIC ALCOHOL-ABUSE - CORRELATION WITH ALCOHOLIC PANCREATITIS

Objectives: To investigate the incidence and histological features of pancreatic fibrosis, including chronic alcoholic pancreatitis, in pati ents with a history of chronic alcohol abuse. Methods: Forty-six autop sy cases of alcoholic dependence syndrome, 53 cases of chronic alcohol ism, and 30 cases of chronic alcoholic pancreatitis were studied histo pathologically. Results: Fibrosis was seen in 33 of 46 cases of alcoho lic dependence syndrome, 20 of 53 cases of chronic alcoholism, and all 30 cases of chronic alcoholic pancreatitis. Fibrosis was categorized into three types: intralobular, perilobular, and mixed intralobular an d perilobular sclerosis. In chronic alcoholic pancreatitis, fibrosis w as found mainly in perilobular, or interlobular, areas, and in some ad vanced cases extended into intralobular areas, so that the pancreatic tissue was completely replaced by fibrosis. Hence, interlobular fibros is was found in all cases of chronic alcoholic pancreatitis. In contra st, in cases that had predominantly intralobular fibrosis, which were usually cases of alcoholic dependence syndrome, the pancreatic tissue had not completely disappeared, even at an advanced stage, and some pa renchymal regeneration similar to that seen in hemochromatosis was obs erved. Conclusion: Interlobular and intralobular pancreatic fibrosis a ssociated with alcohol abuse appears in distinct pathological patterns with differing mechanisms.