Wasbotten Rachel K, Kaur Sarabjit, Davis Ryan M, Nasrullah Ayesha
School of Medicine, University of Missouri-Columbia, Columbia, MO, USA.
Department of Radiology, University of Missouri-Columbia, Columbia, MO, USA.
Radiol Case Rep. 2024 Jul 16;19(10):4138-4141. doi: 10.1016/j.radcr.2024.06.053. eCollection 2024 Oct.
A 60-year-old female with a BRCA2 mutation and a history of breast cancer presented with diffuse abdominal pain and elevated liver enzymes. Imaging revealed a porta-hepatis mass, prompting consideration of hilar cholangiocarcinoma or breast cancer metastasis. Further investigation including biopsy and F-fluorodeoxyglucose positron emission tomography/computed tomography findings were inconsistent with malignancy, leading to investigation of non-neoplastic causes. Elevated IgG4 levels suggested IgG4-related disease, a mass-forming fibroinflammatory condition. This case demonstrates IgG4-related disease exclusively impacting the portal vein and underscores the importance of considering IgG4-related disease in the differential diagnosis of hepatic masses.
一名60岁女性，有BRCA2基因突变及乳腺癌病史，出现弥漫性腹痛和肝酶升高。影像学检查发现肝门部肿块，考虑为肝门部胆管癌或乳腺癌转移。进一步检查包括活检及F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描结果与恶性肿瘤不符，遂对非肿瘤性病因进行调查。IgG4水平升高提示IgG4相关疾病，这是一种形成肿块的纤维炎性疾病。该病例显示IgG4相关疾病仅累及门静脉，并强调在肝肿块鉴别诊断中考虑IgG4相关疾病的重要性。
