Small bowel (small intestine)
Congenital anomalies
Heterotopic pancreas

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 9 February 2018, last major update August 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Heterotopic pancreas[TIAB] small bowel

Cite this page: Gulwani, H. Heterotopic pancreas. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/smallbowelheterotopicpancreas.html. Accessed February 25th, 2018.
Definition / general
  • Also called adenomyoma, myoepithelial hamartoma (although without pancreatic tissue)
  • Incidence of 1 - 14%, affects all ages but peaks in 4 - 6th decade
  • Most common near ampulla of Vater; also stomach, jejunum
  • May cause blockage of duct, leading to infection, cystic dilation and fat necrosis
  • Usually incidental finding at surgery submitted for frozen section but carcinoma may arise from pancreatic heterotopia (Arch Pathol Lab Med 1999;123:707)
Case reports
Gross description
  • Submucosal nodule, intramural mass
  • Yellowish white, lobulated, 0.2 - 4 cm
  • May have central mucosal dimple
Microscopic (histologic) description
  • Widely separated pancreatic acini with minimally developed ducts, well formed acini may be seen (JOP 2007;8:588, Mod Pathol 2003;16:530)
  • Pancreatic heterotopia may be total, only ducts, only acinar cells (exocrine heterotopia), only islet cells (endocrine heterotopia)
  • Adenomyoma: predominance of pancreatic ducts with proliferation of thick smooth muscle bundles of the muscularis around the ducts (seen in periampullary region of the duodenum)
Microscopic (histologic) images

Images hosted on other servers:

Various images

With acinar cell carcinoma

With ductal adenocarcinoma

Differential diagnosis
Additional references