Pigmented histiocytic "Pseudotumoral" reaction due to endoscopic tattooing of the duodenum with India Ink R. Hadhri * , C. Objective: India ink has been used for endoscopic tattooing to facilitate localization of a luminal abnormality at the time of surgery or repeat endoscopic examination. Recognition of this phenomenon is important to prevent misinterpretation of this _nding as other cause of black tissue deposits. Some of them can be easily excluded by microscopic examination; the others, however, necessitate special stains or, as illustrated by our observation, an adequate clinical information! Method: A 76-year-old man was referred for enteroscopy for microcytic anemia. The procedure revealed a 2 cm flat umbilicated lesion of the duodenum. Endoscopic tattooing was performed to guide surgical excision.