Pancreatic acinar metaplasia of the gastric mucosa is a newly recognized entity. Its physiological relevance and association with other pathological conditions in the stomach remain to be elucidated. We studied by immunohistochemistry the expression of growth markers in the gastric mucosa in biopsies from 15 patients with recognized pancreatic metaplasia. Pancreatic metaplasia (both acinar and dispersed forms) was found in routine paraffin sections and confirmed by strong lipase immunoreactivity. In parallel paraffin sections we performed immunostaining for epidermal growth factor (EGF), transforming growth factor-alpha (TGF alpha) and epidermal growth factor receptor (EGFr) using a biotin streptavidin method. Strong expression of TGF alpha but only weak expression of EGF was noted within metaplastic mucosa. EGFr was strongly expressed, not only in areas of pancreatic metaplasia but also in the surrounding gastric mucosa.