Yamagiwa H, Onishi T, Nishii M
Department of Clinical Pathology, Mie University School of Medicine, Tsu.
Rinsho Byori. 1991 Aug;39(8):881-5.
Forty resected cases of heterotopic pancreas (15 of Heinrich's type I and 25 of type II) in the stomach were investigated. Acinic cells were more remarkably positive by pancreatic polypeptide and amylase in the cases of type I consisting of acinic cells, ducts and islet cells compared with those in type II consisting of acinic cells and ducts. Staining behavior by insulin, gastrin, glucagon, somatostatin and serotonin was similar to that of normal pancreas. However, the intestinal epithelium containing goblet cells and pyloric gland-like glands consisting of the cells with clear cytoplasm were not infrequently produced from the ducts in the lesions of type II. Muscle fibers with transition to muscularis mucosae were more frequently intermingled in the lesions of type II compared with type I. Acinic cell-differentiation in the mucosa apart from the main lesion was found in several cases of type II. It was suspected that there are two types of histogenesis for the heterotopic pancreas in the stomach; one arises from the fetal immigration of pancreas tissue in the stomach and the other from the immature gastric mucosal penetration into the submucosa with secondary differentiation to the pancreas tissue.
对40例胃内异位胰腺切除病例（海因里希I型15例，II型25例）进行了研究。与由腺泡细胞和导管组成的II型病例相比，由腺泡细胞、导管和胰岛细胞组成的I型病例中，腺泡细胞对胰多肽和淀粉酶的阳性反应更明显。胰岛素、胃泌素、胰高血糖素、生长抑素和5-羟色胺的染色行为与正常胰腺相似。然而，在II型病变的导管中，常可见到含有杯状细胞的肠上皮和由胞质清亮的细胞组成的幽门腺样腺体。与I型相比，II型病变中更常出现向黏膜肌层过渡的肌纤维。在几例II型病例中，在远离主要病变的黏膜中发现了腺泡细胞分化。推测胃内异位胰腺存在两种组织发生类型；一种源于胰腺组织在胃内的胎儿期迁移，另一种源于未成熟胃黏膜向黏膜下层的穿透并继发分化为胰腺组织。
