Prevalence and pathogenesis of pancreatic acinar tissue at the gastroesophageal junction in children and young adults.
BACKGROUND
Pancreatic acinar tissue (PAT) at the gastroesophageal junction (GEJ) has been reported in 3% of adults with Barrett esophagus (BE) and in 24% of healthy subjects. The pathogenesis of this ectopic tissue is controversial. Both an acquired metaplastic process in the setting of BE and a congenital abnormality have been suggested in adults.


OBJECTIVE
To clarify the origin of PAT at the GEJ.


METHODS
We reviewed material obtained from the GEJ in 69 children and young adults. Each specimen was evaluated by 3 levels stained with hematoxylin-eosin for the presence of PAT, BE, esophagitis, and gastritis. Selected cases were also examined with immunohistochemical stains for lipase, trypsin, and amylase.


RESULTS
In 16% of the study population, PAT was present at the GEJ and was not associated with BE. The prevalence of esophagitis and/or gastritis did not vary significantly between patients with and without PAT.


CONCLUSIONS
Our data suggest that PAT at the GEJ develops independently of inflammation and is, therefore, likely to be congenital.
Popiolek
D
D
Department of Laboratories, North Shore University Hospital, New York University School of Medicine, Manhasset 11030, USA.
Kahn
E
E
Markowitz
J
J
Daum
F
F
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000681:Amylases / Q000378:metabolism; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002828:Choristoma / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D015331:Cohort Studies; D015897:Comorbidity; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D004941:Esophagitis / Q000453:epidemiology / Q000473:pathology; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007223:Infant; D008049:Lipase / Q000378:metabolism; D008297:Male; D010179:Pancreas; D015995:Prevalence; D014357:Trypsin / Q000378:metabolism
D008049:Lipase; D000681:Amylases; D014357:Trypsin