Structural changes of the exocrine pancreas in a patient with cholecystolithiasis

The exocrine pancreas has been studied histologically, morphometrically, and ultrastructurally in a patient with cholecystolithiasis in comparison with three control patients free from gastrointestinal or pancreatic diseases. In the gallstone-bearing patient, acinar cells undergo a significant increase in the average cell area and average zymogenic area (i.e., the portion of acinar cell cytoplasm occupied by zymogen granules). In addition, these cells showed cytological signs of enhanced synthesis of secretory proteins and increased formation and release of zymogen granules. The findings concerning centroacinar/ductular cells are consistent with a significant increase in their number and average cell area that is associated with ultrastructural signs of enhanced functional activity.