title: Pancreatic splenosis mimicking neuroendocrine tumors: microhistological diagnosis by endoscopic ultrasound guided fine needle aspiration.
abstract: BACKGROUND
  Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm.
  
  
  OBJECTIVE
  To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic nodules suspicious for pancreatic splenosis.
  
  
  METHODS
  From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed.
  
  
  RESULTS
  A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6%) cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7), young (mean age: 42 years) and asymptomatic (8). Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients.
  
  
  CONCLUSIONS
  Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules.
authors: Endoscopy Unit, Hospital 9 de Julho, São Paulo, SP, Brazil.
authors: José Celso
authors: JC
authors: Ardengh
authors: César Vivian
authors: CV
authors: Lopes
authors: Rafael
authors: R
authors: Kemp
authors: Eder Rios
authors: ER
authors: Lima-Filho
authors: Filadelfo
authors: F
authors: Venco
authors: José Sebastião dos
authors: JS
authors: Santos
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology*; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012680:Sensitivity and Specificity; D017890:Splenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult