Pancreatic paracoccidioidomycosis: An uncommon diagnostic made by endoscopic ultrasound fine needle aspiration

Paracoccidioidomycosis, or South American blastomycosis, or Lutz disease, is a granulomatous infection caused by fungus. Pancreatic infection with mass formation is very uncommon. We report a case of a 72-year-old man with abdominal pain and weight loss for the past 4 months. Abdominal computed tomography (CT) showed masses in the pancreatic head and body. He was referred to our Clinic for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), with suspicious of pancreatic adenocarcinoma. EUS-FNA was performed with a 22G Pro-Core(®) needle (Cook Medical In., Limerick, Ireland) and cytology material was obtained after three needle passes. The slides were stained and analyzed by a cytopathologist, showing numerous Paracoccidioides forms. It seems to be the first report of this diagnostic issue made by EUS-FNA.