title: Hyalinizing cholecystitis with features of immunoglobulin G4-related disease-coincidence or an unrecognized association? A case report.
abstract: Hyalinizing cholecystitis (HC) is a recently described rare subtype of chronic cholecystitis characterized by dense, paucicellular collagenous transmural fibrosis, which usually replaces the mucosa and muscularis propria. Immunoglobulin (Ig)G4-associated cholecystitis is also a newly described cholecystitis variant characterized by transmural or extramural lymphoplasmacytic inflammation, lymphoid follicles, storiform fibrosis, phlebitis, and increased tissue IgG4-positive plasma cells. We describe a case of cholecystitis in an elderly white man who harbored features of both HC and IgG4-associated cholecystitis. In retrospect, the patient also had a significantly elevated serum IgG4 level. To the best of our knowledge, an association between HC and IgG4-related disease has not been previously described in the literature. Although not entirely conclusive, our observations raise the possibility that some cases of HC represent the end stage of IgG4-related disease.
authors: Department of Pathology & Laboratory Medicine, University of Tennessee Health Science Center, 930 Madison Ave, 5th Floor, Memphis, TN 38163, USA. Electronic address: rajibgupta2011@gmail.com.
authors: Rajib K
authors: RK
authors: Gupta
authors: Baptist Memorial Hospital, 6019 Walnut Grove, Memphis, TN 38120, USA; Pathology Group of the Midsouth/Trumbull Laboratories, 7550 Wolf River Blvd, Suite 200, Germantown, TN 38138, USA. Electronic address: kurt_patton@yahoo.com.
authors: Kurt T
authors: KT
authors: Patton
mesh_terms: D000368:Aged; D002764:Cholecystitis / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D003776:Dental Porcelain / Q000378:metabolism; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology*
chemical_list: D007074:Immunoglobulin G; D003776:Dental Porcelain
keywords: Hyalinizing cholecystitis; IgG4-associated cholecystitis; IgG4-positive plasma cells; IgG4-related disease; Porcelain gallbladder