Immunoglobulin G4-related hepatic inflammatory pseudotumor invading the abdominal wall

• Published in: Clinical journal of gastroenterology Vol. 10; no. 1; pp. 57 - 62
• Main Authors: Miyajima, Shinji, Okano, Akihiro, Ohana, Masaya
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2017
• Subjects: Abdominal Surgery; Abdominal Wall - pathology; Bile Duct Neoplasms - diagnosis; Biopsy; Case Report; Cholangiocarcinoma - diagnosis; Colorectal Surgery; Diagnosis, Differential; Female; Gastroenterology; Granuloma, Plasma Cell - diagnostic imaging; Granuloma, Plasma Cell - immunology; Granuloma, Plasma Cell - pathology; Hepatology; Humans; Immunoglobulin G - blood; Liver - pathology; Liver Diseases - diagnostic imaging; Liver Diseases - immunology; Liver Diseases - pathology; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Middle Aged; Skin - pathology; Surgical Oncology; Tomography, X-Ray Computed; Ultrasonography; Abdominal wall; Hepatic inflammatory pseudotumor; Immunoglobulin G4-related disease; Invasion
• ISSN: 1865-7257; 1865-7265
• DOI: 10.1007/s12328-016-0701-4

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.