Isolated intrapancreatic IgG4-related sclerosing cholangitis

doi:10.3748/wjg.v21.i4.1334

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Jan 28, 2015 (publication date) through Jul 21, 2024

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Jan 28, 2015; 21(4): 1334-1343
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1334

Table 1 Clinical profile of isolated type1 immunoglobulin G4-related sclerosing cholangitis without autoimmune pancreatitis

Case No.	Age	Sex	Year	SerumIgG4	Pancreaticenlargement	Narrowingof MPD	Bile duct biopsy/cytology	IDUS/EUS	Wall thickeningIn lesions without luminal stenosis	Other modalities	Firstdiagnosis	Treatment
(1) Kansai RosaiHospital	82	M	2012	22.8	Atrophic	Normal(MRCP)	Negative(cytology)	Symmetric, smooth wall thickening(EUS)	Yes(CT)	Intenseuptake(PET-CT)	Cholangiocarcinoma	PD
(2) KanazawaUniversity	60	M	2012	14.6	Normal	Normal	InadequateSample(biopsy)Suspicious of adenocarcinoma(cytology)	Symmetric, smooth wall thickening(EUS)	Yes(CT)	Intenseuptake(PET-CT)	CholangiocarcinomaCholangiocarcinomaAdenomyomatosis of gall bladder	PPPD
(3) Kasugai municipalHospital	81	M	2009	76(afteroperation)	Normal	Normal	Suspicious of adenocarcinoma(biopsy)	Symmetric,smooth wall thickening(IDUS)	Yes(CT, IDUS)		Cholangiocarcinoma	PPPD
(4) TokaiUniversity	61	M	2010	509	Normal	Normal	IgG4-SC(biopsy)	Symmetric,smooth wall thickening(IDUS, EUS)	Yes(CT, IDUS, EUS)		IgG4-SC	Predonisolone
(5) YamagataUniversity	87	M	2009	262	Normal	Dilation	No malignancy(biopsy)	Symmetric,smooth wall thickening(IDUS, EUS)	Yes(CT,IDUS, EUS)		IgG4-SC	Endoscopicbiliary drainage

M: Male; F: Female; IDUS: Intraductal ultrasonography; EUS: Endoscopic ultrasonography; PD: Pancreaticoduodenectomy; PPPD: Pylorus-preserving PD; MPD: Main pancreatic duct; CT: Computed tomography; PET-CT: Positron emission tomography-CT; IgG4-SC: Immunoglobulin G4-related sclerosing cholangitis; MRCP: Magnetic resonance cholangiopancreatography.

Table 2 Characteristic features of isolated intrapancreatic IgG4-related sclerosing cholangitis

Isolated intrapancreatic IgG4-SC is rare among isolated IgG4-SC

Isolated intrapancreatic IgG4-SC is misdiagnosed as cholangiocarcinoma of intrapancreatic duct

Frequency of cases with higher serum IgG4 level is low in isolated intrapancreatic IgG4-SC cases

Bile duct wall thickening in lesions without luminal stenosis detected by abdominal CT, EUS and IDUS is useful finding in the diagnosis of isolated intrapancreatic IgG4-SC

IgG4-SC: Immunoglobulin G4-related sclerosing cholangitis; CT: Computed tomography; IDUS: Intraductal ultrasonography; EUS: Endoscopic ultrasonography.

Citation: Nakazawa T, Ikeda Y, Kawaguchi Y, Kitagawa H, Takada H, Takeda Y, Makino I, Makino N, Naitoh I, Tanaka A. Isolated intrapancreatic IgG4-related sclerosing cholangitis. World J Gastroenterol 2015; 21(4): 1334-1343
URL: https://www.wjgnet.com/1007-9327/full/v21/i4/1334.htm
DOI: https://dx.doi.org/10.3748/wjg.v21.i4.1334