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IgG4相关性胆囊炎被误诊为胆囊癌:一例报告

IgG4-related cholecystitis misinterpreted as gallbladder cancer, a case report.

作者信息

Miratashi Yazdi Seyed Amir, Nazar Elham, Vesali Behnoud

机构信息

Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Ann Med Surg (Lond). 2022 Apr 10;77:103615. doi: 10.1016/j.amsu.2022.103615. eCollection 2022 May.

Abstract

INTRODUCTION

Immunoglobulin G4-related disease (IgG4-RD) is a new defined entity with features that factually have been overlapped with other diseases with distinctly diverse treatments and prognoses.

CASE PRESENTATION

This report describes a 50-year-old woman who presented with abdominal pain from 3 months ago. The patient underwent open cholecystectomy with Roux-en-Y hepaticojejunostomy due to suspicious of malignancy. The histological examinations revealed acute on chronic cholecystitis with extensive fibrosis and many inflammatory cells infiltration composed of plasmacells and eosinophils without any evidence of malignancy. Pathological and immunohistochemical examination for IgG4 compatible with IgG4-RD. So, pathological assessment is essential for the diagnosis.

CONCLUSION

IgG4-RD in gastrointestinal tract frequently misinterpret as malignancy before surgery, and surgeon should notice this disease in the differential diagnosis in order to choose the treatment.

摘要

引言

免疫球蛋白G4相关性疾病(IgG4-RD)是一种新定义的疾病实体,其特征实际上与其他疾病有重叠,而这些疾病的治疗方法和预后截然不同。

病例报告

本报告描述了一名50岁女性,她3个月前开始出现腹痛。由于怀疑患有恶性肿瘤,该患者接受了开腹胆囊切除术及Roux-en-Y肝空肠吻合术。组织学检查显示为慢性胆囊炎急性发作,伴有广泛纤维化以及许多由浆细胞和嗜酸性粒细胞组成的炎症细胞浸润,未发现任何恶性肿瘤的证据。IgG4的病理及免疫组化检查符合IgG4-RD诊断。因此,病理评估对诊断至关重要。

结论

胃肠道IgG4-RD在手术前常被误诊为恶性肿瘤,外科医生在鉴别诊断时应注意这种疾病,以便选择合适的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d51/9142613/0c0e216313ef/gr1.jpg

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