Cholangiocarcinoma Masquerading as IgG4-related Sclerosing Cholangitis.
10.15279/kpba.2016.21.3.168
- Author:
Sangyoung YI
1
;
Dong Hui CHO
;
Seungha HWANG
;
Kyunghwan OH
;
Hyeon Jeong KIM
;
Jihun KIM
;
Myung Hwan KIM
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mhkim@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
IgG4-related sclerosing cholangitis;
Cholangiocarcinoma;
Autoimmune pancreatitis
- MeSH:
Adenocarcinoma;
Aged;
Bile Ducts, Extrahepatic;
Biopsy;
Cholangiocarcinoma*;
Cholangitis, Sclerosing*;
Constriction, Pathologic;
Diagnosis, Differential;
Dilatation;
Humans;
Liver Function Tests;
Male;
Pancreatic Ducts;
Pancreatitis;
Phenobarbital;
Weight Loss
- From:Korean Journal of Pancreas and Biliary Tract
2016;21(3):168-173
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
IgG4-related sclerosing cholangitis (IgG4-SC) represents a rare but clinically challenging differential diagnosis in patients with biliary strictures which can be mistaken for cholangiocarcinoma. We present a case of a 73-year-old male presented with abdominal discomfort and weight loss. Biliary images showed long-segment luminal narrowing of extrahepatic bile duct associated with prominent enhanced wall thickening, but luminal patency was preserved. Pancreatic images revealed segmental irregular narrowing of main pancreatic duct without upstream duct dilatation. His liver function tests and CA19-9 level were normal. Putting all findings together, IgG4-SC associated with autoimmune pancreatitis was strongly suspected. However, endobiliary biopsy of extrahepatic bile duct revealed adenocarcinoma which was not resectable due to celiac axis involvement. Because there is an overlap in biliary imaging findings between IgG4-SC and cholangiocarcinoma, biopsy is essential for adequate differential diagnosis. We present a case of cholangiocarcinoma masquerading as IgG4-SC based on clinical and imaging findings.
