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Eosinophilic Pancreatitis Is a Benign Mimicker of Pancreatic Neoplasm: A Systematic Review.

To the Editor: E osinophilic pancreatitis (EP) is a rare form of chronic pancreatitis, with a limited number of cases reported to date in the literature. It is characterized by either local or diffuse infiltration of the pancreas with eosinophils, along with elevated serum immunoglobulin E (IgE) levels. Fibrosis and eosinophilic inflammatory infiltrates typically result in pancreatic masses or enlargement, leading to obstructive symptoms that mimic pancreatic neoplasm. Eosinophilic pancreatitis is difficult to diagnose because of low incidence with limited awareness, lack of specific signs and symptoms without biopsy, and sometimes limited access to endoscopic ultrasound (EUS) with fine-needle aspiration/biopsy (FNA/FNB) or IgE levels. Given similar presentation to pancreatic neoplasm, patients may undergo surgery for a “false-positive” with EP diagnosed thereafter. The aim of this systematic review is to chronicle all cases of EP and to describe clinical and radiographic presentation and outcomes.