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Presented by Ralph Hruban, M.D. and prepared by Jeffrey Seibel, M.D. Ph.D.
Case 6: This 62 year old male presented with ill-defined abdominal pain.
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1. Question
Week 87: Case 6
This 62 year old male presented with ill-defined abdominal pain.images/042202case6a.jpg
images/042202case6b.jpg
images/042202case6c.jpgCorrect
Answer: Eosinophilic pancreatitis
Histology: This pancreas showed a dramatic infiltrate of eosinophils.
Discussion: Eosinophilic pancreatitis is a rare form of pancreatitis. These patients often have an elevated peripheral eosinophil count and there appears to be an association between eosinophilic pancreatitis and eosinophilic gastroenteritis. Most cases, like the one shown here, are characterized by an intense diffuse inflammatory infiltrate composed primarily of eosinophils. As noted in Case 2, eosinophils can also be seen in lymphoplasmacytic sclerosing chronic pancreatitis. However, in the case of lymphoplasmacytic sclerosing chronic pancreatitis, the eosinophils are less numerous.
Patients with eosinophilic pancreatitis should be carefully evaluated for the presence of parasitic infection. A careful drug history should be also be obtained, as some cases appear to be drug-induced.
Incorrect
Answer: Eosinophilic pancreatitis
Histology: This pancreas showed a dramatic infiltrate of eosinophils.
Discussion: Eosinophilic pancreatitis is a rare form of pancreatitis. These patients often have an elevated peripheral eosinophil count and there appears to be an association between eosinophilic pancreatitis and eosinophilic gastroenteritis. Most cases, like the one shown here, are characterized by an intense diffuse inflammatory infiltrate composed primarily of eosinophils. As noted in Case 2, eosinophils can also be seen in lymphoplasmacytic sclerosing chronic pancreatitis. However, in the case of lymphoplasmacytic sclerosing chronic pancreatitis, the eosinophils are less numerous.
Patients with eosinophilic pancreatitis should be carefully evaluated for the presence of parasitic infection. A careful drug history should be also be obtained, as some cases appear to be drug-induced.
