Diagnosis of intrapancreatic accessory spleen by endoscopic ultrasound-guided fine-needle aspiration mimicking a pancreatic neoplasm: a case report and review of literature

2019 ◽  
Vol 13 (2) ◽  
pp. 287-297 ◽  
Author(s):  
Anas Renno ◽  
Michael Hill ◽  
Yousef Abdel-Aziz ◽  
Hany Meawad ◽  
Amanda Lenhard ◽  
...  
Keyword(s):  
Case Report ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Pancreatic Neoplasm ◽  
Accessory Spleen ◽  
Needle Aspiration ◽  
Review Of Literature ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Intrapancreatic Accessory Spleen

Fine-Needle Aspiration of Intrapancreatic Accessory Spleen, Mimic of Pancreatic Neoplasms

2010 ◽  
Vol 134 (10) ◽  
pp. 1474-1478
Author(s):  
Jingmei Lin ◽  
Xin Jing
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Pancreatic Neoplasm ◽  
Accessory Spleen ◽  
Inflammatory Cells ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Intrapancreatic Accessory Spleen ◽  
Thin Walled

Abstract Intrapancreatic accessory spleen (IPAS) is a congenital abnormality, which mimics neoplasm. Distinguishing IPAS from pancreatic neoplasm/malignancy is extremely important from a treatment perspective. We report the case of a 67-year-old asymptomatic man who had a 1.3-cm, incidentally detected, pancreatic tail mass. The mass was round, well-circumscribed, and hypervascular with uniform enhancement. The image findings were highly suggestive of a pancreatic endocrine neoplasm. An endoscopic ultrasound-guided fine-needle aspiration was performed. Conventional smears revealed a polymorphous population of lymphocytes admixed with a subset of other inflammatory cells. Hematoxylin-eosin–stained cell block sections showed conspicuous thin-walled blood vessels in addition to inflammatory cells. Immunostaining for CD8 demonstrated strong positivity in endothelial cells of the thin-walled vessels. By correlating the cytologic findings with the result of immunostaining, we rendered the diagnosis of IPAS. Our experience supports the view that endoscopic ultrasound-guided fine-needle aspiration may enable a reliable, preoperative diagnosis of IPAS and thus prevent unnecessary surgery.

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