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IgG4-related cholecystitis misinterpreted as gallbladder cancer, a case report
Seyed Amir Miratashi Yazdi1, Elham Nazar2, Behnoud Vesali2
1Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Annals of Medicine and Surgery (2012)
|May 31, 2022
Summary
Immunoglobulin G4-related disease (IgG4-RD) can mimic malignancy, particularly in the gastrointestinal tract. Early pathological assessment is crucial for accurate diagnosis and appropriate treatment selection.
Area of Science:
- Immunology
- Gastroenterology
- Pathology
Background:
- Immunoglobulin G4-related disease (IgG4-RD) is an emerging clinical entity.
- IgG4-RD shares overlapping features with various diseases, complicating diagnosis and treatment.
- Accurate differentiation is critical due to diverse prognoses and therapeutic strategies.
Observation:
- A 50-year-old woman presented with abdominal pain and underwent surgery for suspected malignancy.
- Histological examination revealed acute on chronic cholecystitis with significant fibrosis and inflammatory infiltrate.
- Immunohistochemical analysis confirmed IgG4-related disease (IgG4-RD).
Findings:
- Pathological and immunohistochemical examinations are essential for diagnosing IgG4-RD.
- Gastrointestinal IgG4-RD is frequently misdiagnosed as malignancy pre-operatively.
- The case highlights the importance of considering IgG4-RD in the differential diagnosis of abdominal pathologies.
Implications:
- Surgical and medical management strategies for IgG4-RD differ significantly from those for malignancy.
- Increased awareness among clinicians, especially surgeons, can improve diagnostic accuracy.
- Timely diagnosis of IgG4-RD can prevent unnecessary aggressive treatments and improve patient outcomes.
