Heterotopic pancreatic tissue in the gall bladder neck and lymph node surrounding cystic duct identified during cholecystectomy for chronic calculous cholecystitis: a rare case report from Syria

Heterotopic pancreas is a congenital anomaly defined as the presence of the pancreatic tissue outside its normal location, which is usually discovered incidentally. We describe a rare case of heterotopic pancreatic tissue in the neck and the node surrounding the cystic duct of the gallbladder. A 33-year-old female presented with right upper quadrant abdominal pain aggravated after fat meals. The diagnosis was made as chronic cholecystitis. Laparoscopic cholecystectomy was performed. Pathologic examination showed a lobulated nodule connected to the cystic duct. Microscopically, this node consisted of all components of pancreatic tissue. Localization of heterotopic pancreatic tissue in the gallbladder is exceedingly rare. Less than 40 cases of heterotopic pancreas in the gallbladder have been reported worldwide. The ectopic pancreas is an extraordinary congenital entity. Although pancreatic tissue in the lymph node is an exceptional finding, pathologists should be aware of it because it may be confused with tumor or metastasis.