Immunoglobulin G4-associated sclerosing cholangitis mimicking cholangiocarcinoma.
Immunoglobulin G4-related lymphoplasmacytic sclerosing disease is an emerging disease. Recently, it has been shown to be responsible for autoimmune pancreatitis-induced strictures of the bile duct mimicking cholangiocarcinoma. Making a diagnosis of immunoglobulin G4-associated sclerosing cholangitis requires a high index of suspicion. The differential diagnoses include primary sclerosing cholangitis, cholangiocarcinoma, and pancreatic cancer. The preoperative diagnosis is likely to be missed due to the lack of specific symptoms; a clinical presentation that may mimic other disorders, especially malignant biliary strictures; and the lack of specific imaging features. This article reports on a 51-year-old man with immunoglobulin G4-associated sclerosing cholangitis without autoimmune pancreatitis. He underwent resection of his extrahepatic bile duct with a hepaticojejunostomy. The diagnosis was confirmed after a histopathological examination. This case highlights the obstacles to making a preoperative diagnosis of immunoglobulin G4-associated sclerosing cholangitis.
Chung
D T M
DT
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. tmchung@gmail.com
Tang
C N
CN
Lai
E C H
EC
Yang
G P C
GP
Li
M K W
MK
D001650:Bile Duct Neoplasms / Q000175:diagnosis; D017734:Bile Ducts, Extrahepatic / Q000473:pathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000175:diagnosis*; D015209:Cholangitis, Sclerosing / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007582:Jejunostomy / Q000379:methods; D008297:Male; D008875:Middle Aged
D007074:Immunoglobulin G