Xanthogranulomatous pancreatitis is uncommon but important to recognize, since it may be mistaken for a pancreatic neoplasm on imaging studies.
Findings on imaging studies:
(1) low density solid (non-cystic) mass in the pancreas
(2) hyperintense on T2-weighted images
(3) isointense on T1-weighted images
(4) variable peripancreatic fibrosis
Pathologic features:
(1) chronic inflammation with a mixed inflammatory cell infiltrate
(2) numerous macrophages, many of which are foamy and lipid-laden
(3) macrophages are CD68 positive but negative for S100
Differential diagnosis:
(1) chronic pancreatitis
(2) pseudotumor
(3) extranodal Rosai-Dorfman disease
(4) Tangier disease or other metabolic storage disease
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Specialty: Gastroenterology
