title: Immunoglobulin G4-related hepatic inflammatory pseudotumor invading the abdominal wall.
abstract: A 50-year-old woman presented with epigastralgia. Computed tomography (CT) of the abdomen revealed a 6-cm well-enhanced mass extending from the left lobe of the liver to the abdominal wall, suggestive of cholangiocarcinoma. Liver and skin mass biopsies did not provide evidence of hepatic malignancy but were rich in plasma cells and sclerotic lesions. Subsequent detection of elevated serum immunoglobulin G4 (IgG4) led to a diagnosis IgG4-related inflammatory pseudotumor (IPT) of the liver. Treatment with systemic corticosteroids resulted in rapid clinical improvement. This case is the first report of an IgG4-related hepatic IPT invading the abdominal wall.
authors.affiliation: Gastroenterology, Tenri Hospital, 200 Mishima-chou, Tenri, Nara Prefecture, Japan. sinjimiya@hotmail.co.jp.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miyajima
authors.affiliation: Gastroenterology, Tenri Hospital, 200 Mishima-chou, Tenri, Nara Prefecture, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Okano
authors.affiliation: Gastroenterology, Tenri Hospital, 200 Mishima-chou, Tenri, Nara Prefecture, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Ohana
mesh_terms: D034861:Abdominal Wall / Q000473:pathology*; D001650:Bile Duct Neoplasms / Q000175:diagnosis; D001706:Biopsy; D018281:Cholangiocarcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006104:Granuloma, Plasma Cell / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D007074:Immunoglobulin G
keywords: Abdominal wall; Hepatic inflammatory pseudotumor; Immunoglobulin G4-related disease; Invasion