A Fatty Surprise: Lipogranulomatous Inflammation in a Peripancreatic Node

A 62-year-old man with a history of metabolic dysfunction-associated steatotic liver disease underwent an endoscopic ultrasound (EUS) for further evaluation. Imaging revealed a 2.7 × 2.2 cm hyperechoic lymph node located between the pancreatic head and the common bile duct. The node appeared steatotic in nature. EUS-guided biopsy demonstrated benign lymphoid tissue with lympholipogranulomatous inflammation and no evidence of malignancy. While such nodes are often incidental, this type of lipogranulomatous inflammation is an uncommon finding on EUS, with limited literature describing its clinical implications.