Yamagiwa H, Onishi N, Nishii M
Department of Clinical Pathology, Mie University School of Medicine, Tsu, Japan.
Acta Pathol Jpn. 1992 Apr;42(4):249-54. doi: 10.1111/j.1440-1827.1992.tb02537.x.
Ordinary histological investigation has suggested that heterotopic pancreas of the stomach may have two types of histogenesis; one is development from immigrated fetal pancreas tissue, and the other is development from primitive gastric mucosal epithelium following penetration into the submucosa with subsequent erroneous differentiation into pancreas tissue. It is suspected that type-I lesions include the majority of cases caused by immigration from fetal pancreas, and that some type-II cases arise through erroneous differentiation of primitive gastric mucosal epithelium. With regard to immunohistochemical findings, cells positive for pancreatic polypeptide and amylase were much more numerous in the acini of type-I cases compared with type-II cases. Positive cells were found not infrequently in the acini of type-II cases after staining for pancreatic polypeptide, insulin, glucagon, somatostatin, serotonin, and gastrin. On the other hand, a small number of cells in islets were not infrequently positive for alpha 1-antitrypsin, alpha 1-antichymotrypsin, and amylase. It is considered that in the heterotopic pancreas, ductal cells have the potential to differentiate into acinar cells and islet cells, as is the cases in the orthotopic pancreas.
普通组织学研究表明，胃异位胰腺可能有两种组织发生类型；一种是由迁移的胎儿胰腺组织发育而来，另一种是原始胃黏膜上皮穿透至黏膜下层后错误分化为胰腺组织而发育形成。据推测，I型病变包括大多数由胎儿胰腺迁移引起的病例，而一些II型病例则是通过原始胃黏膜上皮的错误分化产生的。关于免疫组化结果，与II型病例相比，I型病例腺泡中胰多肽和淀粉酶阳性的细胞要多得多。在对胰多肽、胰岛素、胰高血糖素、生长抑素、5-羟色胺和胃泌素进行染色后，II型病例的腺泡中也时常发现阳性细胞。另一方面，胰岛中的少数细胞也时常对α1-抗胰蛋白酶、α1-抗糜蛋白酶和淀粉酶呈阳性。据认为，在异位胰腺中，导管细胞与正常胰腺中的情况一样，具有分化为腺泡细胞和胰岛细胞的潜力。
