Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Department of Pathology and Laboratory Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Clin J Gastroenterol. 2021 Dec;14(6):1733-1739. doi: 10.1007/s12328-021-01526-z. Epub 2021 Sep 27.
Inflammatory pseudotumor (IPT) is a benign tumor mass composed of chronic infiltration of inflammatory cells and fibrous tissue. IgG4-RD (related disease) in the hepatobiliary system has been widely recognized and includes IgG4-related hepatic IPT. This report describes a patient with IgG4-related hepatic IPT with sclerosing cholangitis. A 75-year-old woman was admitted to our hospital for the treatment of rectal cancer. Abdominal contrast-enhanced computed tomography revealed a low-density mass, 2.5 cm in diameter, in the left lateral lobe. Magnetic resonance imaging showed that the mass was slightly hypointense on T1-weighted images and slightly hyperintense on T2-weighted images. Based on these results, we made a diagnosis of cholangiolocellular carcinoma, and we performed a left hepatectomy. Histopathological examination showed that the mass was composed of fibrous stroma with dense lymphoplasmacytic infiltration. Immunohistochemically, IgG4-positive plasma cells were observed. The final diagnosis was IgG4-related hepatic IPT with sclerosing cholangitis. IgG4-related IPT is a relatively rare disease that can occur in any organ of the body. Although the accurate diagnosis of IgG4-related hepatic IPT remains difficult, IgG4-RD should be included in the differential diagnosis of liver tumors and histological analysis performed.
炎性假瘤（IPT）是一种由慢性浸润的炎症细胞和纤维组织组成的良性肿瘤肿块。IgG4 相关疾病（related disease）在肝胆系统中已得到广泛认可，包括 IgG4 相关肝 IPT。本报告描述了一例伴有硬化性胆管炎的 IgG4 相关肝 IPT 患者。一名 75 岁女性因直肠癌入住我院。腹部增强 CT 显示左外叶直径 2.5cm 的低密度肿块。磁共振成像显示肿块在 T1 加权图像上呈稍低信号，在 T2 加权图像上呈稍高信号。基于这些结果，我们诊断为胆管细胞癌，并进行了左半肝切除术。组织病理学检查显示肿块由纤维基质和密集的淋巴浆细胞浸润组成。免疫组化检查显示 IgG4 阳性浆细胞。最终诊断为伴有硬化性胆管炎的 IgG4 相关肝 IPT。IgG4 相关 IPT 是一种相对罕见的疾病，可发生于身体的任何器官。虽然 IgG4 相关肝 IPT 的准确诊断仍然具有挑战性，但应将 IgG4-RD 纳入肝脏肿瘤的鉴别诊断，并进行组织学分析。
