A histopathological study on the islets of Langerhans and ductal epithelial metaplasia in atrophic lobuli of pancreas.

In autopsy material isolated islets of Langerhans are frequently encountered in the fatty or the fibrous tissue replacing the pancreatic lobuli. The incidence of isolated islets of Langerhans was 27.0% in the file of a series of randomly selected 100 autopsy cases and increased with advancing age. Fifteen cases of these 27 showed multiple foci and the total number of foci counted 60. Fifty-two foci (86.7%) were found in the subcapsular area. Clusters of elastic fibers were found in 36 foci (60.0%). Small pancreatic ducts with goblet cell metaplasia were found in 29 foci (48.0%) in the surrounding tissue of the remaining islets of Langerhans. Squamous metaplasia was identified in only 1 focus (0.2%), and luminal dilatation of the duct was found in 4 foci (0.7%). Serial sections showed that the small duct ended without connection to acinar cells. "The isolated islets of Langerhans" should be the result of the atrophy of pancreatic lobuli subsequent to disappearance of acinar cells.