کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4138395 | 1272145 | 2012 | 7 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Immunoglobulin G4-related sclerosing cholangitis: pathologic features and histologic mimics Immunoglobulin G4-related sclerosing cholangitis: pathologic features and histologic mimics](/preview/png/4138395.png)
Since immunoglobulin G4 (IgG4)-related sclerosing cholangitis was first described in 2004, this condition has been recognized as a distinct entity characterized by unique pathologic features. Affected bile ducts show diffuse wall thickening, which represents transmural sclerosing inflammation composed of a dense lymphoplasmacytic infiltrate and fibrosis arranged at least focally in a storiform pattern. A diffuse IgG4-positive plasma cell infiltrate is demonstrable by immunohistochemistry. More than 90% of patients with IgG4-related sclerosing cholangitis have type 1 autoimmune pancreatitis, the remaining presenting as isolated cholangitis. The diagnosis requires a multidisciplinary approach, in which pathologic examination has a critical role. Tissue diagnosis on biopsy specimens (ie, bile duct biopsy, liver needle biopsies) is important, particularly for patients with isolated cholangitis, given the fact that radiological findings of IgG4-cholangitis are not reliable enough for establishing the diagnosis. Furthermore, serum IgG4 levels can be, albeit mildly, elevated in other biliary disorders. Histologic mimics of IgG4-related sclerosing cholangitis include primary sclerosing cholangitis, follicular cholangitis, and sclerosing cholangitis with granulocytic epithelial lesion, the latter 2 being recently described entities.
Journal: Seminars in Diagnostic Pathology - Volume 29, Issue 4, November 2012, Pages 205–211