Korean J Gastroenterol.  2011 Dec;58(6):353-356. 10.4166/kjg.2011.58.6.353.

A Case of Cholesterol Granuloma in Pancreas

• Jung CW
• Kim BJ
• Park SO
• Jo AR
• Ha JK
• Park SK
• Kim HS

• KMID: 1043336
• DOI: http://doi.org/10.4166/kjg.2011.58.6.353

Abstract

Cholesterol granuloma is a histological term used for the description of a tissue response to a foreign body such as cholesterol crystals. Cholesterol granuloma is histologically characterized as fibrous granulation tissue containing cholesterol crystals within surrounding giant cells. Cases of cholesterol granuloma of the pancreas are very rare. We report a case of a 47-year old male who had a cholesterol granuloma of the pancreas. Abdominal CT showed 24 mm-sized cyst in the pancreas and peri-pancreatic regional mass infiltrating to the stomach. PET-CT revealed increased 18F-FDG uptake at the cyst and peri-pancreatic mass. Thus, Whipple's operation was done. The disease was confirmed by surgical pathologic examination of the tissue. Pathologic examination of resected specimen showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells. We report on this case and give a brief review of the literature.

Keyword

Cholesterol granuloma; Pancreas

MeSH Terms

*Cholesterol
Diagnosis, Differential
Fluorodeoxyglucose F18/chemistry/diagnostic use
Granuloma, Foreign-Body/*pathology/radionuclide imaging/surgery
Humans
Male
Middle Aged
Pancreas/pathology
Positron-Emission Tomography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. (A) Non-enhanced abdominal computerized tomography showed round cystic mass on the pancreas body portion with multiple peripheral rim calcifications. (B) Enhanced abdominal computerized tomography, 4 months later, showed diffuse thickening of the wall on the pancreas and the invasion of soft tissue mass to peripancreatic region (black arrow).

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  Fig. 2. PET-CT showed increased 18F-FDG uptake in the rim of the cystic mass and peripancreatic mass. FDG, fluoro-deoxy-glucose.

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  Fig. 3. Gross specimen showed fibrous encapsulated cyst and dark brown colored hard materials in the cyst and peripancreatic region. FDG, fluoro-deoxy-glucose.

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  Fig. 4. Microscopic finding of resected specimen. It showed a large number of spindle shaped cholesterol crystals (cholesterol cleft) surrounded by multinucleated giant cells and hemosiderin deposits (A: H&E, ×40, B: H&E, ×400).

Reference

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