Small intestine & ampulla

Congenital anomalies

Heterotopic pancreas

Topic Completed: 1 August 2012

Minor changes: 14 September 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Heterotopic pancreas[TIAB] small bowel

Hanni Gulwani, M.B.B.S.
Page views in 2020: 1,035
Page views in 2021 to date: 1,081
Cite this page: Gulwani H. Heterotopic pancreas. website. Accessed December 8th, 2021.
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)
Differential diagnosis
Additional references
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