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Eosinophilic pancreatitis

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 5 November 2014, last major update August 2012
Copyright: (c) 2001-2014, PathologyOutlines.com, Inc.


● Very rare (<20 cases reported)
● Usually peripheral eosinophilia and multiorgan involvement (Am J Surg Pathol 2003;27:334)
● May have elevated serum IgE
● May have hypereosinophilic syndrome: eosinophil count >1500 cells/mm3 sustained over >6 months, history of allergic manifestations such as rhinitis and bronchial asthma, involvement of other organ systems such as skin, heart, GI tract, no other recognizable cause for eosinophilia, including parasitic infections and leukemia
● May present as a pancreatic mass or common bile duct obstruction simulating malignancy

Case reports

● Stillborn fetus (34 weeks) with anencephaly and diabetic mother (Gastroenterology Research 2011;4:174 (online))
● 14 year old boy with pancreatic mass (Can J Gastroenterol 2006;20:361)
● 38 year old woman (Indian J Gastroenterol 2007;26:136)

Micro description

● Diffuse periductal, acinar and septal eosinophilic infiltrate affecting arteries and veins or clusters of eosinophils associated with pseudocysts
● Also fibrosis

Micro images

14 year old boy: images from pancreas, duodenum, lymph node

Stillborn fetus (34 weeks) with anencephaly and diabetic mother
Hypertrophy and hyperplasia of islets with prominent septal, peri-insular and islet eosinophilic infiltrate limited to pancreatic parenchyma, with relative sparing of exocrine pancreas

Differential diagnosis

Inflammatory myofibroblastic tumor
Langerhans’ histiocytosis
Lymphoplasmacytic sclerosing pancreatitis: eosinophils focal
Pancreatic allograft rejection
Systemic mastocytosis

End of Pancreas > Pancreatitis > Eosinophilic pancreatitis

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