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KMID : 1188320150090040556
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Gut and Liver
2015 Volume.9 No. 4 p.556 ~ p.560
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IgG4-Associated Cholangitis Can Mimic Hilar Cholangiocarcinoma
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Victor M. Zaydfudim
Andrew Y. Wang
Eduard E. de Lange
Zimin Zhao
Christopher A. Moskaluk
Todd W. Bauer
Reid B. Adams
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Abstract
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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.
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KEYWORD
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IgG4 cholangiopathy, Autoimmune cholangiopathy, Autoimmune pancreatitis, Biliary stricture, Hilar mass
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