scholarly journals A Case of Non-spesific Inflammatory Sclerosing Cholangitis Masquerading Bile Duct Carcinoma

Author(s):  
Ouki YASUI ◽  
Makoto SATO
2007 ◽  
Vol 74 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Shigeki Yokomuro ◽  
Yasuo Arima ◽  
Yoshiaki Mizuguchi ◽  
Tetsuya Shimizu ◽  
Yutaka Kawahigashi ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Malene Theilmann Thinesen ◽  
Ove B. Schaffalitzky de Muckadell ◽  
Sönke Detlefsen

IgG4-related disease is characterized by lymphoplasmacytic inflammation and fibrosis, often leading to mass-forming lesions in different organs. When IgG4-related disease affects the bile ducts, it is called IgG4-related sclerosing cholangitis. A 74-year-old male complained of dysphagia and abdominal pain. Endoscopic retrograde cholangiography and magnetic resonance cholangiography revealed bile duct changes suspicious of a bile duct carcinoma or cholangitis. Liver biopsy showed storiform fibrosis, lymphoplasmacytic infiltration, obliterative phlebitis, and a portal-based inflammatory nodule with expansion of a portal tract. Hot spots revealed 339 IgG4-positive cells per high power field (HPF) and an IgG4/IgG ratio of 72%. Eight months earlier, an inguinal lymph node had been removed, showing expanded interfollicular zones and increased plasma cells. Hot spots revealed 593 IgG4-positive cells and an IgG4/IgG ratio of 92%. The serum IgG4 of the patient was elevated nearly 10 times upper limit of normal. The diagnosis of IgG4-related sclerosing cholangitis associated with IgG4-related lymphadenopathy was made. There was good response to treatment with prednisolone and azathioprine. The differentiation of IgG4-related sclerosing cholangitis from primary sclerosing cholangitis and bile duct carcinoma is often difficult. Liver biopsy only rarely contributes to this setting, but we describe and report in detail a case where liver biopsy showed a portal-based inflammatory nodule with the characteristic features of this disease.


1986 ◽  
Vol 22 (4) ◽  
pp. 536
Author(s):  
Y W Park ◽  
S S Kim ◽  
H J Kim ◽  
Y D Joh ◽  
B H Chun

1999 ◽  
Vol 274 (1) ◽  
pp. 554
Author(s):  
Rujun Kang ◽  
Hiroyuki Saito ◽  
Yoshito Ihara ◽  
Eiji Miyoshi ◽  
Nobuto Koyama ◽  
...  

2001 ◽  
Vol 120 (5) ◽  
pp. A575
Author(s):  
Masateru Murakami ◽  
Akira Tsuchida ◽  
Tamito Sasaki ◽  
Yousuke Kawasaki ◽  
Kenji Morinaka ◽  
...  

Gut ◽  
1966 ◽  
Vol 7 (5) ◽  
pp. 433-437 ◽  
Author(s):  
J G Rankin ◽  
A P Skyring ◽  
S J Goulston

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