Related Experiment Video
Updated: Feb 6, 2026

Determining Glucose Metabolism Kinetics Using 18F-FDG Micro-PET/CT
Published on: May 2, 2017
Hepatic Involvement of IgG4-Related Disease Presenting as Multiple Hypermetabolic Masses on FDG PET/CT
Abstract:
A 45-year-old man was found with multiple hepatic masses in CT/MR, suggesting liver metastases of unknown origin. F-FDG PET/CT showed several hypermetabolic masses in the liver; patchy increased uptake in the pancreas; and FDG-avid lymph nodes in the neck, axilla, and mediastinum. Histopathology with biopsy revealed enriched IgG4-positive lymphoplasmacytic cells infiltrating in the liver, pancreas, and lymph nodes, which confirmed the diagnosis of IgG4-related disease. The lesions were diminished on follow-up PET/CT 3 months after treatment with prednisone. This case illustrated that multifocal FDG-avid hepatic mass might be the involvement of IgG4-related disease, which should be differentiated from malignancies.
Insights
Multifocal hepatic masses on PET/CT may indicate IgG4-related disease, a condition mimicking cancer. Early diagnosis and treatment with prednisone effectively reduced lesions in this case.
Area of Science:
- Immunology
- Oncology
- Radiology
Background:
- Multiple hepatic masses on imaging can suggest metastatic disease.
- IgG4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect multiple organs.
- Differentiating IgG4-RD from malignancy is crucial for appropriate treatment.
Related Concept Videos
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug
Hepatic Portal System
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
Atomic Mass

