A case of inflammatory pseudotumor of the gallbladder and bile duct

A rare cause of obstructive jaundice is presented. A 43-yr-old man developed jaundice with fever and weight loss, and showed lymphadenopathy, reticular shadows on chest roentgenogram, deranged liver function tests, eosinophilia, low values of complement proteins, and hypergammaglobulinemia. There was a stricture throughout the bilateral hepatic ducts and common hepatic and bile ducts with dilated intrahepatic bile ducts on imagings. The walls of the gallbladder and common bile duct were thickened due to diffuse granulomatous lesions of unknown etiology, composed mainly of plasma cells, lymphocytes, and fibroblasts identical with inflammatory pseudotumor. The same histological findings also were observed in the lung and lymph nodes. Jaundice disappeared, with reduced thickening of the common bile duct wall. All clinical and laboratory abnormalities subsided after high-dose prednisolone therapy, starting when dyspnea developed. There is no similar case in the literature.