- Author:
Victor M ZAYDFUDIM
1
;
Andrew Y WANG
;
Eduard E DE LANGE
;
Zimin ZHAO
;
Christopher A MOSKALUK
;
Todd W BAUER
;
Reid B ADAMS
Author Information
- Publication Type:Case Reports
- Keywords: IgG4 cholangiopathy; Autoimmune cholangiopathy; Autoimmune pancreatitis; Biliary stricture; Hilar mass
- MeSH: Aged; Bile Ducts/pathology/surgery; Cholangitis/blood/*diagnosis; Diagnosis, Differential; Humans; Immunoglobulin G/*blood; Klatskin Tumor/blood/*diagnosis; Liver/pathology/surgery; Male
- From:Gut and Liver 2015;9(4):556-560
- CountryRepublic of Korea
- Language:English
- Abstract: IgG4-associated cholangitis can mimic hilar cholangiocarcinoma. Previously reported patients with IgG4-associated cholangitis mimicking cholangiocarcinoma had elevated serum IgG4 levels and long-segment biliary strictures. However, in the absence of other diagnostic criteria for malignancy, IgG4-associated cholangitis should remain a consideration among patients with normal serum IgG4 and a hilar mass suspicious for cholangiocarcinoma. The presence of a hilar mass and a malignant-appearing biliary stricture in two patients with normal serum IgG4 prompted further evaluation and subsequent concomitant liver and bile duct resection and reconstruction. The diagnosis of IgG4-associated cholangitis was established during the pathologic evaluation of the resected specimens. IgG4-associated cholangitis is a known imitator of hilar cholangiocarcinoma and should be considered in the differential diagnosis even among serologically IgG4-negative patients with a hilar mass prior to operative resection.