title: IgG4-Associated Cholangitis Can Mimic Hilar Cholangiocarcinoma.
abstract: 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.
authors.affiliation: Section of Hepatobiliary and Pancreatic Surgery, Division of Surgical Oncology, USA.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Zaydfudim
authors.affiliation: Division of Gastroenterology and Hepatology, USA.
authors.forename: Andrew Y
authors.initials: AY
authors.lastname: Wang
authors.affiliation: Department of Radiology and Medical Imaging, USA.
authors.forename: Eduard E
authors.initials: EE
authors.lastname: de Lange
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, VA, USA.
authors.forename: Zimin
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, VA, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Moskaluk
authors.affiliation: Section of Hepatobiliary and Pancreatic Surgery, Division of Surgical Oncology, USA.
authors.forename: Todd W
authors.initials: TW
authors.lastname: Bauer
authors.affiliation: Section of Hepatobiliary and Pancreatic Surgery, Division of Surgical Oncology, USA.
authors.forename: Reid B
authors.initials: RB
authors.lastname: Adams
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000473:pathology / Q000601:surgery; D002761:Cholangitis / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D018285:Klatskin Tumor / Q000097:blood / Q000175:diagnosis*; D008099:Liver / Q000473:pathology / Q000601:surgery; D008297:Male
chemical_list: D007074:Immunoglobulin G
keywords: Autoimmune cholangiopathy; Autoimmune pancreatitis; Biliary stricture; Hilar mass; IgG4 cholangiopathy