Dataset Information

IgG4-related cholecystitis misinterpreted as gallbladder cancer, a case report.

ABSTRACT:

Introduction

Immunoglobulin G4-related disease (IgG4-RD) is a new defined entity with features that factually have been overlapped with other diseases with distinctly diverse treatments and prognoses.

Case presentation

This report describes a 50-year-old woman who presented with abdominal pain from 3 months ago. The patient underwent open cholecystectomy with Roux-en-Y hepaticojejunostomy due to suspicious of malignancy. The histological examinations revealed acute on chronic cholecystitis with extensive fibrosis and many inflammatory cells infiltration composed of plasmacells and eosinophils without any evidence of malignancy. Pathological and immunohistochemical examination for IgG4 compatible with IgG4-RD. So, pathological assessment is essential for the diagnosis.

Conclusion

IgG4-RD in gastrointestinal tract frequently misinterpret as malignancy before surgery, and surgeon should notice this disease in the differential diagnosis in order to choose the treatment.

SUBMITTER: Miratashi Yazdi SA

PROVIDER: S-EPMC9142613 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

IgG4-related cholecystitis misinterpreted as gallbladder cancer, a case report.

Miratashi Yazdi Seyed Amir SA Nazar Elham E Vesali Behnoud B

Annals of medicine and surgery (2012) 20220410

<h4>Introduction</h4>Immunoglobulin G4-related disease (IgG4-RD) is a new defined entity with features that factually have been overlapped with other diseases with distinctly diverse treatments and prognoses.<h4>Case presentation</h4>This report describes a 50-year-old woman who presented with abdominal pain from 3 months ago. The patient underwent open cholecystectomy with Roux-en-Y hepaticojejunostomy due to suspicious of malignancy. The histological examinations revealed acute on chronic chol ...[more]

PMID: 35638058

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Project description:BackgroundChest pain is a common reason for admission to the Emergency Department and aortic disease is a relatively frequent cause amongst the total number of admissions due to chest pain. IgG4-related disease (IgG4-RD) is a multi-organ immune-mediated condition that mimics several malignant, infectious, and inflammatory disorders.Case summaryWe report a rare case of IgG4-related aortitis complicated with severe aortic regurgitation and multivessel coronary artery disease in a 64-year-old man with a history of atypical chest pain. The diagnosis was made performing transthoracic echocardiography, transoesophageal echocardiography, and left heart catheterization; the aortitis was an incidental finding discovered by computed tomography angiography. Unusually, the positron emission tomography-computed tomography (PET-CT) scans did not reveal metabolic activity in the aortic wall. This last finding prompted us to exclude more aggressives arteritis (such as Horton's disease or Takayasu arteritis); syphilis infection and other infective or autoimmune diseases were excluded with laboratory tests. The patient underwent cardiac surgery with replacement of both the aortic valve and the ascending aorta, also performing a coronary aortic bypass graft (CABG). Despite the PET-CT scans were negative in the aortic wall, the histological specimens showed diffuse lymphoid infiltration, fibro-atheromatosis lesions, and medium-interstitial hyperplasia compatible with aortic atherosclerosis and IgG4-RD. The post-surgery course was free of complications and the patient was discharged in good clinical condition. He was referred to the Rheumatologic Department and a corticosteroid therapy has been started.DiscussionThe growing recognition of IgG4-related systemic disease as a clinical entity underscores the importance of considering this diagnosis in patients with any type of idiopathic aortitis and aortic valve disease. Noteworthy, the PET-CT scans could be negative in this disease, so histological exams are mandatory to make the diagnosis; in our case an unusual post-surgery histopathological finding prompted us to diagnose a rare, unrecognized disease and allowed us to treat the patient properly.

Dataset Information

IgG4-related cholecystitis misinterpreted as gallbladder cancer, a case report.

Introduction

Case presentation

Conclusion

Publications

IgG4-related cholecystitis misinterpreted as gallbladder cancer, a case report.

Similar Datasets

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