Pancreatic acinar metaplasia (PAM) is a common incidental histopathologic finding present in approximately 20-25% of patients undergoing an esophagogastroduodenoscopy.

[2] There is some epidemiological evidence to suggest is associated with gastroesophageal reflux and Helicobacter gastritis.

[1] There is no evidence to suggest it is pre-neoplastic, like Barrett's esophagus.

[citation needed] A slight increased incidence with age suggests it is an acquired lesion,[1] as may be seen in a true metaplasia.

The histopathologic features of pancreatic acinar metaplasia are: (1) the presence of cell clusters that resembles a many-lobed "berry" (an acinus), with (2) cells that are histomorphologically identical to the glands of the exocrine pancreas.