Hepatic inflammatory pseudotumor related with IgG4

Legkiy, Oleksandr; Wajda, Jarosław; Ćwierz, Anna; Wysocka, Joanna; Komorowski, Andrzej L.

doi:10.1016/j.gastre.2019.02.022

Cited by 2 publications

(5 citation statements)

References 6 publications

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Section: Discussionmentioning

confidence: 99%

“…Histologically, IPT of the liver is characterized by proliferation of fibrous tissue and inflammatory cells, including plasma cells, neutrophils, lymphocytes, eosinophils, macrophages, and/or multinucleated giant cells. 12 Inflammatory pseudotumors of the liver typically resolve spontaneously. 1 Treatment approaches are controversial and can include conservative and surgical modalities.…”

Section: Discussionmentioning

confidence: 99%

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Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica

Kanagalingam

Dulymamode

Jafroodifar

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Inflammatory pseudotumors of the liver are rare, non-neoplastic liver tumors. Due to the nonspecific clinical presentation, imaging features, and histopathological findings, they can mimic malignant tumors requiring invasive diagnostics. We present a case of a 61-year-old female patient with a history of type 2 diabetes mellitus, hypothyroidism, hyperlipidemia, and polymyalgia rheumatica who had initially presented with abdominal pain for 3 weeks. Further workup showed normal liver chemistries and tumor markers: AFP and CA 19-9. Magnetic resonance imaging (MRI) of the abdomen showed a segment 6 lesion measuring 4.1 × 4.0 × 3.7 cm. A liver biopsy then confirmed the diagnosis of an inflammatory pseudotumor of the liver with negative IgG4. On follow-up imaging, a rapid growth of this liver lesion was noted. Laparoscopy was done but did not show any distinct liver lesion. Follow-up imaging confirmed a decrease in the size of the mass. Interestingly, the patient had been on a higher dose of steroids for her polymyalgia rheumatic leading up to the follow-up imaging. This is the first case of an inflammatory pseudotumor of the liver in a patient with polymyalgia rheumatica. With this case, we would like to increase the awareness for inflammatory pseudotumors of the liver as a differential diagnosis of liver lesions in patients with underlying autoimmune disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica

Kanagalingam

Dulymamode

Jafroodifar

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

View full text Add to dashboard Cite

show abstract

“…9 Histopathological analysis remains the cornerstone of diagnosis demonstrating a storiform pattern, obliterative phlebitis, and mild to moderate eosinophil infiltrate with positive IgG4 plasma cells. 10,11 The cornerstone of treatment is derived from case reports with immunosuppressive therapy as the primary. Corticosteroids are the first line with rapid response seen in the majority of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory data will be notable for elevated liver enzymes in a cholestatic pattern. 9,10 Typically ultrasound is the first diagnostic imaging of choice which demonstrates single or multifocal hypoechoic or hyperechoic masses with increased through transmission and septation. 9 CT imaging with or without contrast notes low attenuation with several patterns of enhancement.…”

Section: Discussionmentioning

confidence: 99%

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Fevers, Sweats, Weight Loss, Oh My! When IgG4 Related Disease Comes Knocking. . .

Essien

Wolfley

Tate

et al. 2021

Clin Med Insights Case Rep

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Immunoglobulin G4-related systemic disease (IgG4-RSD) is a fibro-inflammatory immune condition characterized by IgG4 positive plasma cells, fibrosis, and frequently elevated serum IgG4 level. Akin to sarcoidosis, IgG4-RSD is a systemic disease with diverse organ manifestations linked by common histopathologic features. IgG4-RSD typically presents sub acutely without significant constitutional symptoms or fever. Hepatic Inflammatory pseudotumor (HIP) is a rare manifestation of IgG4-RSD composed of dense lymphoplasmacytic infiltrate and extensive fibrosis. We present an older Asian male who presented with acute onset of fever and weight loss found to have IgG4-RSD complicated by a HIP and concomitant MSSA abscess.

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Hepatic inflammatory pseudotumor related with IgG4

Cited by 2 publications

References 6 publications

Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica

Enlarging Liver Mass: Inflammatory Pseudotumor in a Patient With Polymyalgia Rheumatica

Fevers, Sweats, Weight Loss, Oh My! When IgG4 Related Disease Comes Knocking. . .

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