Hepatolithiasis associated with intrahepatic heterotopic pancreas: a case report and literature review

ABSTRACT: Intrahepatic heterotopic pancreas is rarely reported in the literature. Here, we report a case of a 39-year-old male with intrahepatic heterotopic pancreas associated with primary cholesterol hepatolithiasis. Computed tomography (CT) scans revealed multiple cholesterol stones in intrahepatic bile ducts of the left lobe concomitant with intrahepatic cholangiectases. These observations were confirmed by magnetic resonance cholangiopaneretography (MRCP). The patient underwent transabdominal left hepatic lobectomy. Postoperative histological examination of the resected specimen showed pancreatic tissues distributed along the wall of the bile duct and composed of acinar cells and duct elements without islets of Langerhans, therefore strongly suggesting that the heterotopic pancreas occurred in response to chronic injury due to the primary cholesterol hepatolithiasis and was derived from the biliary epithelial cells. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1461819267158980.