Fine‐needle aspiration biopsy of an intra‐abdominal inflammatory mass secondary to a penetrating duodenal ulcer mimicking neoplasm

Peptic ulcers complicated by penetration into the surrounding tissue and presenting as an intra‐abdominal mass simulating a malignancy are uncommon. We report on a case of a 56‐yr‐old physician with a 40‐yr history of peptic disease. Due to recent and transitory right flank pain, an ultrasound then a computed tomography scan demonstrated a 4‐cm retropancreatic mass. A fine‐needle aspiration biopsy (FNAB) of the mass showed an acute and chronic inflammatory exudate. After a course of medical treatment for peptic ulcer disease and 5 mo after the biopsy, the mass remarkably decreased in size. In view of the clinical and FNAB findings, the lesion likely developed as a result of penetration of the duodenal ulcer into the retropancreatic space. Awareness of this uncommon complication of peptic gastroduodenal ulcer disease is helpful in the diagnosis of this benign lesion. A failure in making a firm diagnosis by considering the aspirate material as nonrepresentative may lead to an unnecessary repeat biopsy or an invasive procedure. Diagn. Cytopathol. 25:301–302, 2001. © 2001 Wiley‐Liss, Inc.