Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2015; 21(4): 1334-1343
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1334
Isolated intrapancreatic IgG4-related sclerosing cholangitis
Takahiro Nakazawa, Yushi Ikeda, Yoshiaki Kawaguchi, Hirohisa Kitagawa, Hiroki Takada, Yutaka Takeda, Isamu Makino, Naohiko Makino, Itaru Naitoh, Atsushi Tanaka
Takahiro Nakazawa, Itaru Naitoh, Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
Yushi Ikeda, Naohiko Makino, Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan
Yoshiaki Kawaguchi, Department of Gastroenterology, Tokai University School of Medicine, Kanagawa 259-1153, Japan
Hirohisa Kitagawa, Isamu Makino, Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan
Hiroki Takada, Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai 486-8510, Japan
Yutaka Takeda, Department of Surgery, Kansai Rosai Hospital, Osaka 660-8511, Japan
Atsushi Tanaka, Department of Medicine, Teikyo University School of Medicine, Tokyo 173-8606, Japan
Author contributions: Nakazawa T analyzed data and wrote the paper; Ikeda Y collected clinical data; Kawaguchi Y collected clinical data; Kitagawa H collected clinical data; Takada H collected clinical data; Takeda Y collected clinical data; Makino I collected clinical data; Makino N collected clinical data; Naitoh I analyzed data and wrote the paper; and Tanaka A analyzed data.
Supported by Health Labor Science Research Grants from Research on Measures for Intractable Diseases, the Intractable Hepato-Biliary Diseases Study Group in Japan.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takahiro Nakazawa, MD, Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. tnakazaw@med.nagoya-cu.ac.jp
Telephone: +81-52-8538211 Fax: +81-52-8520952
Received: June 20, 2014
Peer-review started: June 22, 2014
First decision: July 9, 2014
Revised: July 29, 2014
Accepted: September 5, 2014
Article in press: September 5, 2014
Published online: January 28, 2015
Processing time: 220 Days and 21.5 Hours
Core Tip

Core tip: If stenosis of intrapancreatic bile duct is present and no abnormal findings of pancreas are detected, cholangiocarcinoma is suspected. Recently, we have encountered 5 isolated intrapancreatic immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) cases that were not associated with autoimmune pancreatitis, three of which were pathologically investigated after surgical operation. Isolated intrapancreatic IgG4-SC is difficult to diagnose, especially if the IgG4 level remains normal. Thus, this type of IgG4-SC should be suspected in addition to cholangiocarcinoma and pancreatic cancer if stenosis of intrapancreatic bile duct is present.