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Inflammatory pseudotumors mimicking intrahepatic cholangiocarcinoma of the liver; IgG4-positivity and its clinical significance

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Author(s)
Keun Soo AhnKoo Jeong KangYong Hoon KimTae Jin LimHye Ra JungYu Na KangJung Hyeok Kwon
Keimyung Author(s)
Jung, Hye RaKang, Yu NaAhn, Keun SooKang, Koo JeongKim, Yong HoonLim, Tae JinKwon, Jung Hyeok
Department
Dept. of Pathology (병리학)
Dept. of Surgery (외과학)
Dept. of Radiology (영상의학)
Journal Title
Journal of Hepatobiliary Pancreat Sci
Issued Date
2012
Volume
19
Issue
4
Keyword
LiverInflammatory pseudotumorCholangiocarcinomaIgG4
Abstract
Background:
Inflammatory pseudotumor (IPT) of the liver is a benign condition with a good prognosis. However, it is difficult to distinguish clinical and radiological findings of IPT from those of malignancies. The aims of this study are to determine the clinical, radiological, and pathological characteristics, particularly relating to the role of the autoimmune mechanism in the development of inflammatory pseudotumours (IPTs) of the liver, and to suggest appropriate diagnostic and therapeutic strategy.

Study design:
The clinical, diagnostic, and pathological characteristics including IgG4 immunohistochemical stain and follow-up data of 22 IPT patients were retrospectively analyzed.


Results:
The patients were 16 men and 6 women with a mean age of 59 years. Fifteen patients (68.2%) had associated biliary diseases. Of the 16 patients treated conservatively, the masses completely resolved in 10 patients, and reduced in size in 5 patients within the first 6 months. The remaining 6 patients were treated by surgical resection. IgG4 staining of 17 tissue samples from 22 patients were negative, most of the infiltrate being of fibrohistiocytic type, whereas 4 of 5 lymphoplasmacytic cells of dominant tumors show positive staining of IgG4. Although IgG4-related sclerosing cholangitis was mostly of lymphoplasmacytic type, other histological and clinical characteristics were similar in both types of IPTs.

Conclusions:
IPTs of the liver can be diagnosed based on radiological and pathological findings by needle biopsy. Although the lymphoplasmacytic type of IPTs seems to correspond to IgG4-related disease, as assessed by IgG4 immunohistochemical stain, its clinical significance is unknown. Although most IPTs can be resolved with conservative therapy, surgical resection should be considered in cases of uncertain biopsy result, presumed malignant lesion, combination with other pathology, or lack of response to conservative management.
Keimyung Author(s)(Kor)
정혜라
강유나
안근수
강구정
김용훈
임태진
권중혁
Publisher
School of Medicine
Citation
Keun Soo Ahn et al. (2012). Inflammatory pseudotumors mimicking intrahepatic cholangiocarcinoma of the liver; IgG4-positivity and its clinical significance. Journal of Hepatobiliary Pancreat Sci, 19(4), 405–412. doi: 10.1007/s00534-011-0436-z
Type
Article
ISSN
1868-6974
Source
https://onlinelibrary.wiley.com/doi/abs/10.1007/s00534-011-0436-z
DOI
10.1007/s00534-011-0436-z
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33784
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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