IgG4-related Sclerosing Cholangitis Mimicking Cholangiocarcinoma Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration

Intern Med. 2020 Apr 1;59(7):945-950. doi: 10.2169/internalmedicine.3905-19. Epub 2019 Dec 26.

Abstract

A 58-year-old man was referred for obstructive jaundice. Imaging modalities revealed the presence of multiple pancreatic tumors and the stenosis of the middle common bile duct due to a hypoenhanced localized tumor. The multiple pancreatic tumors were histopathologically diagnosed as autoimmune pancreatitis by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). To differentiate between IgG4-related sclerosing cholangitis (IgG4-SC) and cholangiocarcinoma, we diagnosed the biliary tumor as IgG4-SC by EUS-FNA because of insufficient pathological materials obtained in a transpapillary manner. We herein report a case of IgG4-SC diagnosed by EUS-FNA.

Keywords: IgG4; IgG4-related diseases; fine-needle aspiration; obstructive jaundice; pancreatitis; sclerosing cholangitis.

Publication types

  • Case Reports

MeSH terms

  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / physiopathology*
  • Cholangiocarcinoma / diagnosis*
  • Cholangiocarcinoma / physiopathology*
  • Cholangitis, Sclerosing / diagnosis*
  • Cholangitis, Sclerosing / physiopathology*
  • Diagnosis, Differential
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / methods
  • Humans
  • Immunoglobulin G / blood*
  • Male
  • Middle Aged

Substances

  • Immunoglobulin G