A Case of Autoimmune Cholangitis Misdiagnosed for Cholangiocarcinoma: How to Avoid Unnecessary Surgical Intervention?
| Autor: | Igor Ignjatovic, Srbislav M. Knežević, Djordje M. Knežević, Marjan Micev, Vladimir Dugalic, Slavko Matic, Marko Bogdanovic |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Systemic disease Pathology medicine.medical_specialty Cholangitis lcsh:Medicine Bile Duct Neoplasm Unnecessary Procedures Bile Duct Carcinoma Autoimmune Diseases Cholangiocarcinoma Diagnosis Differential differential diagnosis medicine autoimmune cholangitis Humans Autoimmune pancreatitis Autoimmune disease Common bile duct business.industry lcsh:R General Medicine Middle Aged medicine.disease Immunohistochemistry medicine.anatomical_structure Bile Duct Neoplasms Immunoglobulin G Differential diagnosis Pancreas business |
| Zdroj: | Srpski Arhiv za Celokupno Lekarstvo, Vol 143, Iss 5-6, Pp 337-340 (2015) |
| ISSN: | 0370-8179 |
| Popis: | Introduction. Autoimmune cholangitis or immunoglobulin G4-associated cholangitis (IAC) has been recently regarded as a new clinical and histopathological entity and is a part of a complex autoimmune disorder - IgG4-related systemic disease (ISD). ISD is an autoimmune disease with multi-organic involvement, characterized with IgG4-positive plasmocytic infiltration of various tissues and organs with a consequent sclerosis, which responds well to steroid therapy. Most commonly affected organs are the pancreas (autoimmune pancreatitis, [AIP]) and the common bile duct (IAC). IAC and cholangiocarcinoma (CCA) share many clinical, laboratory and imaging findings. Case Outline. We present a case of a 60-year-old male with a biliary stricture of a common bile duct, which was clinically considered as a bile duct carcinoma and treated surgically. Definite histopathological findings and immunohistochemistry revealed profound chronic inflammation, showing lymphoplasmacytic IgG-positive infiltration of a resected part of a common bile duct, highly suggestive for the diagnosis of IAC. In addition, postoperative IgG4 serum levels were also increased. Conclusion. It is of primary clinical importance to make a difference between IAC and CCA, in order to avoid unnecessary surgical intervention. Therefore, IAC should be considered in differential diagnosis in similar cases. |
| Databáze: | OpenAIRE |
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