Groove Pancreatitis

 Changes are centered around minor papilla and involve “groove” between pancreas and duodenum

image May mimic pancreatic neoplasm, including cystic neoplasm


• Duodenal wall around minor ampulla is thickened with marked fibrosis involving muscular propria and adjacent head of pancreas
image Fibrosis extends into head of pancreas and may involve common bile duct

image Duodenal fibrosis is frequently accompanied by cysts lined by granulation tissue

• Nonparaduodenal pancreas frequently shows dilated ducts with inspissated secretions and prominent interlobular fibrosis

• Brunner gland hyperplasia is commonly seen

Fibrosis and Cysts
Gross photograph of a pancreaticoduodenectomy specimen shows a mass-like lesion beneath the duodenal mucosa. Note the paraduodenal zone of fibrosis with numerous small cysts image .

Brunner Gland Hyperplasia
Prominent Brunner gland hyperplasia in the region of the minor ampulla frequently accompanies groove pancreatitis.

Muscularis Propria Fibrosis
High-power view of groove pancreatitis shows exuberant fibrosis image within the muscularis propria.

Cyst Formation
Cyst formation image is frequently seen in groove pancreatitis, accounting for one of the plethora of names used for this entity, “paraduodenal wall cyst.”



• Paraduodenal pancreatitis

• Cystic dystrophy of heterotopic pancreas

• Paraduodenal wall cyst

• Pancreatic hamartoma of duodenum

• Myoadenomatosis


• Distinct form of pancreatitis that results in fibrosis of paraduodenal region in vicinity of minor ampulla

• Significant because dense fibrosis and irregular borders can mimic neoplasm


Combination of Factors

• Developmental anomalies and environmental exposure
image Anatomical/functional variations in region of minor papilla, such as pancreatic divisum, predispose to development of groove pancreatitis

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Apr 20, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Groove Pancreatitis

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