Exocrine pancreatic tissue in human liver: a metaplastic process?

Numerous microscopic foci of exocrine pancreatic tissue consisting of acini and small ductules were distributed throughout the liver of a 41-year-old patient with severe posthepatitic cirrhosis. The acinar cells were characterized by abundant zymogen granules on electron microscopic examination and a strong reaction with antibodies to alpha-amylase on immunoperoxidase staining. The pancreatic tissue was associated with proliferations of bile ductules within areas of fibrosis. No relationship with hepatocytes was observed. A metaplastic origin of the pancreatic tissue from the intrahepatic biliary epithelium is suggested.