Case RePort : IgG4-Associated Cholangitis Can Mimic Hilar Cholangiocarcinoma

• Published in: Gut and liver Vol. 9; no. 4; pp. 556 - 560
• Main Authors: Victor M. Zaydfudim, Andrew Y. Wang, Eduard E. De Lange, Zimin Zhao, Christopher A. Moskaluk, Todd W. Bauer, Reid B. Adams
• Format: Journal Article
• Language: Korean
• Published: 대한소화기기능성질환·운동학회 30.07.2015
• Subjects: Autoimmune cholangiopathy; Autoimmune pancreatitis; Biliary stricture; Hilar mass; IgG4 cholangiopathy
• ISSN: 1976-2283; 2005-1212

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. (Gut Liver 2015;9:556-560)