Fine-needle aspiration cytology findings from a case of pancreatic heterotopia at the gastroesophageal junction

Pancreatic heterotopia is a well-recognized entity occurring at a variety of sites in the gastrointestinal tract. However, only a handful of patients have been described with this abnormality at the gastroesophageal junction. Cytologic descriptions of pancreatic heterotopia in general are scant in the literature. We report the cytologic findings of ectopic pancreatic tissue at the gastroesophageal junction in a 41-year-old female, which was initially identified by endoscopic ultrasound and fine-needle aspiration. Cytologic examination of Papanicolaou-stained smears revealed clusters of benign-appearing ducts and small acini mixed with inflammatory cells. Hematoxylin and eosin staining of the Tru-Cut biopsy revealed benign pancreatic tissue. The patient underwent surgical resection due to symptoms related to inflammation of the heterotopic pancreatic tissue. The increasing use of endoscopic ultrasound and fine-needle aspiration for the diagnosis of gastrointestinal tumors makes the recognition of pseudoneoplastic lesions at unusual sites an important step in optimum patient management.