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Presented by Ralph Hruban, M.D. and prepared by Jeffrey T. Schowinsky, M.D.
Case 1: This adult male was found to have an asymptomatic, partially cystic, 1.5 cm mass in the tail of the pancreas while being imaged for another indication.
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Question 1 of 1
1. Question
Week 269: Case 1
This adult male was found to have an asymptomatic, partially cystic, 1.5 cm mass in the tail of the pancreas while being imaged for another indication.images/41706RH1a.jpg
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images/41706RH1e.jpgCorrect
Answer: Ectopic spleen in the pancreas
Histology: This well-demarcated mass was composed of nodules of well-differentiated mature lymphocytes (white pulp) surrounded by more of a vascularized lymphoid tissue (red pulp).
Discussion: Heterotopic splenic tissue can rarely be found within the parenchyma of the tail of the pancreas. This heterotopic splenic tissue is important to recognize because, as in this case, it can mimic a pancreatic neoplasm. The characteristic architecture and the finding of mature lymphocytes help establish the correct diagnosis. In rare cases, an epidermoid cyst can arise within an intrapancreatic heterotopic spleen. In these cases the lesion can mimic a cystic neoplasm of the pancreas. Regardless of whether or not the pancreatic heterotopic spleen is associated with an epidermoid cyst, these lesions are entirely benign.
Incorrect
Answer: Ectopic spleen in the pancreas
Histology: This well-demarcated mass was composed of nodules of well-differentiated mature lymphocytes (white pulp) surrounded by more of a vascularized lymphoid tissue (red pulp).
Discussion: Heterotopic splenic tissue can rarely be found within the parenchyma of the tail of the pancreas. This heterotopic splenic tissue is important to recognize because, as in this case, it can mimic a pancreatic neoplasm. The characteristic architecture and the finding of mature lymphocytes help establish the correct diagnosis. In rare cases, an epidermoid cyst can arise within an intrapancreatic heterotopic spleen. In these cases the lesion can mimic a cystic neoplasm of the pancreas. Regardless of whether or not the pancreatic heterotopic spleen is associated with an epidermoid cyst, these lesions are entirely benign.
