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Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma

A 71-year-old man on prednisolone for immunoglobulin (Ig) G4-related renal disease showed increased carbohydrate antigen (CA) 19–9 level; abdominal enhanced computed tomography (CT) showed a lesion in the left lateral segment and dilatation of the peripheral biliary duct. He was referred to our hosp...

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Autores principales: Hamano, Ai, Yamada, Reiko, Kurata, Kazunari, Tsuboi, Junya, Inoue, Hiroyuki, Tanaka, Kyosuke, Horiki, Noriyuki, Takei, Yoshiyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Singapore 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886829/
https://www.ncbi.nlm.nih.gov/pubmed/33037585
http://dx.doi.org/10.1007/s12328-020-01245-x
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author Hamano, Ai
Yamada, Reiko
Kurata, Kazunari
Tsuboi, Junya
Inoue, Hiroyuki
Tanaka, Kyosuke
Horiki, Noriyuki
Takei, Yoshiyuki
author_facet Hamano, Ai
Yamada, Reiko
Kurata, Kazunari
Tsuboi, Junya
Inoue, Hiroyuki
Tanaka, Kyosuke
Horiki, Noriyuki
Takei, Yoshiyuki
author_sort Hamano, Ai
collection PubMed
description A 71-year-old man on prednisolone for immunoglobulin (Ig) G4-related renal disease showed increased carbohydrate antigen (CA) 19–9 level; abdominal enhanced computed tomography (CT) showed a lesion in the left lateral segment and dilatation of the peripheral biliary duct. He was referred to our hospital for detailed examination for suspected intrahepatic cholangiocarcinoma. CT and magnetic resonance imaging findings were similar to those for intrahepatic cholangiocarcinoma. However, endoscopic retrograde cholangiopancreatography showed a smooth narrowing of the bile duct which suggested inflammatory disease. Liver biopsy was performed; IgG4-related hepatic inflammatory pseudotumor (IPT) was diagnosed. IgG4-related hepatic IPTs are rare diseases that develop in association with the development of sclerosing cholangitis. Most of these lesions develop in the hepatic hilum and the imaging findings of these tumors are similar to those of hilar cholangiocarcinomas. Thus, hepatic IPTs are difficult to differentiate from malignancy; in some cases, surgical resection has been considered for establishing the diagnosis. In the present case, we could diagnose hepatic IPT on the basis of liver biopsy, which is the recommended approach in cases of suspected hepatic IPT.
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spelling pubmed-78868292021-03-03 Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma Hamano, Ai Yamada, Reiko Kurata, Kazunari Tsuboi, Junya Inoue, Hiroyuki Tanaka, Kyosuke Horiki, Noriyuki Takei, Yoshiyuki Clin J Gastroenterol Case Report A 71-year-old man on prednisolone for immunoglobulin (Ig) G4-related renal disease showed increased carbohydrate antigen (CA) 19–9 level; abdominal enhanced computed tomography (CT) showed a lesion in the left lateral segment and dilatation of the peripheral biliary duct. He was referred to our hospital for detailed examination for suspected intrahepatic cholangiocarcinoma. CT and magnetic resonance imaging findings were similar to those for intrahepatic cholangiocarcinoma. However, endoscopic retrograde cholangiopancreatography showed a smooth narrowing of the bile duct which suggested inflammatory disease. Liver biopsy was performed; IgG4-related hepatic inflammatory pseudotumor (IPT) was diagnosed. IgG4-related hepatic IPTs are rare diseases that develop in association with the development of sclerosing cholangitis. Most of these lesions develop in the hepatic hilum and the imaging findings of these tumors are similar to those of hilar cholangiocarcinomas. Thus, hepatic IPTs are difficult to differentiate from malignancy; in some cases, surgical resection has been considered for establishing the diagnosis. In the present case, we could diagnose hepatic IPT on the basis of liver biopsy, which is the recommended approach in cases of suspected hepatic IPT. Springer Singapore 2020-10-09 2021 /pmc/articles/PMC7886829/ /pubmed/33037585 http://dx.doi.org/10.1007/s12328-020-01245-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Report
Hamano, Ai
Yamada, Reiko
Kurata, Kazunari
Tsuboi, Junya
Inoue, Hiroyuki
Tanaka, Kyosuke
Horiki, Noriyuki
Takei, Yoshiyuki
Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
title Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
title_full Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
title_fullStr Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
title_full_unstemmed Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
title_short Difficulty in differentiating between IgG4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
title_sort difficulty in differentiating between igg4-related hepatic inflammatory pseudotumor and intrahepatic cholangiocarcinoma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886829/
https://www.ncbi.nlm.nih.gov/pubmed/33037585
http://dx.doi.org/10.1007/s12328-020-01245-x
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