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Case Reports
. 2015 Fall;19(4):e145-7.
doi: 10.7812/TPP/14-238.

Isolated Pancreatic Histoplasmosis: An Unusual Suspect of Pancreatic Head Mass in an Immunocompetent Host

Avin Aggarwal, Shashank Garg
Case Reports

Isolated Pancreatic Histoplasmosis: An Unusual Suspect of Pancreatic Head Mass in an Immunocompetent Host

Avin Aggarwal et al. Perm J. 2015 Fall.

Abstract

Histoplasmosis is endemic to the Mississippi and Ohio River valley regions in the US. It usually affects patients with underlying immunodeficiency but can also be seen in immunocompetent hosts. Although gastrointestinal involvement is common in the setting of disseminated histoplasmosis, isolated gastrointestinal involvement is uncommon. We report a case of isolated pancreatic histoplasmosis in an immunocompetent patient, presenting as painless jaundice and pancreatic head mass.

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Conflict of interest statement

Statement The author(s) have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Abdominal computed tomography scan axial view with intravenous contrast: pancreatic head mass with amorphous internal calcifications (long arrow) abutting the portal vein (short arrow) and intrahepatic biliary dilatation (double arrow).
Figure 2.
Figure 2.
Abdominal computed tomography scan coronal view with intravenous contrast: Pancreatic head mass (long arrow) with portal vein compression (short arrow) and extra- and intrahepatic biliary dilatation (black arrow).
Figure 3.
Figure 3.
Abdominal magnetic resonance imaging (T1 weighted) with and without intravenous contrast: cavitary mass in the head of the pancreas with thick septations and peripheral enhancement (arrow).
Figure 4.
Figure 4.
Classic granulomas (arrow) in associated portal nodes with visible normal duodenal mucosa (arrowheads) on hematoxylin and eosin stain.
Figure 5.
Figure 5.
Magnified granuloma wall with rare dark-stained yeast forms (black arrows) with Gomori methenamine silver stain.
See this image and copyright information in PMC

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