Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma

Resheq, Yazid J.; Quaas, Alexander; Renteln, Daniel von; Schramm, Christoph; Lohse, Ansgar W.; Lüth, Stefan

doi:10.1016/j.dld.2013.03.007

Cited by 22 publications

(5 citation statements)

References 38 publications

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“…In contrast to IgG4‐SC, however, IgG4‐positive cells are rare in the peripheral portal tracts in PSC. Numerous IgG4‐positive cells may also appear in cholangiocarcinomas , and >50 IgG4‐positive cells per HPF were found in 9% of 54 resected specimens . Thus, the diagnosis of IgG4‐SC is difficult to establish based on IgG4‐immunostaining alone, and histologic findings must be thoroughly evaluated.…”

Section: Methodsmentioning

confidence: 99%

Clinical practice guidelines for IgG4‐related sclerosing cholangitis

Kamisawa

Nakazawa

Tazuma

et al. 2019

J Hepato Biliary Pancreat

121

143

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IgG4‐related sclerosing cholangitis (IgG4‐ SC ) is a distinct type of cholangitis frequently associated with autoimmune pancreatitis and currently recognized as a biliary manifestation of IgG4‐related disease. Although clinical diagnostic criteria of IgG4‐ SC were established in 2012, differential diagnosis from primary sclerosing cholangitis and cholangiocarcinoma is sometimes difficult. Furthermore, no practical guidelines for IgG4‐ SC are available. Because the evidence level of most articles retrieved through searching the PubMed, Cochrane Library, and Igaku Chuo Zasshi databases was below C based on the systematic review evaluation system of clinical practice guidelines MINDS 2014, we developed consensus guidelines using the modified Delphi approach. Three committees (a guideline creating committee, an expert panelist committee for rating statements according to the modified Delphi method, and an evaluating committee) were organized. Eighteen clinical questions ( CQ s) with clinical statements were developed regarding diagnosis (14 CQ s) and treatment (4 CQ s). Recommendation levels for clinical statements were set using the modified Delphi approach. The guidelines explain methods for accurate diagnosis, and safe and appropriate treatment of IgG4‐ SC .

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Section: Methodsmentioning

confidence: 99%

Clinical practice guidelines for IgG4‐related sclerosing cholangitis

Kamisawa

Nakazawa

Tazuma

et al. 2019

J Hepato Biliary Pancreat

121

143

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“…The initial biopsy was also suggestive, but IgG4-positive plasma cells can be seen in the peritumoral infiltrate of CCA and pancreatic adenocarcinoma (20 IgG4positive plasma cells per high-power field) and in up to 40% of extrahepatic CCA related to interleukin-10 expression. (10,11) Using a cutoff of 50 IgG4-positive plasma cells per high-power field on biopsy specimens may be more specific for IgG4-RD and avoid missing malignancy. (12) Very elevated CA 19-9 levels are more suggestive of CCA.…”

Section: Discussionmentioning

confidence: 99%

Hilar cholangiocarcinoma associated with immunoglobulin G4‐positive plasma cells and elevated serum immunoglobulin G4 levels

Azeem

Ajmera

Hameed

et al. 2018

Hepatology Communications

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Immunoglobulin G4 (IgG4)‐related disease is a fibroinflammatory systemic disorder with multiorgan involvement. Proximal bile duct involvement results in IgG4‐related sclerosing cholangitis, which is characterized by a lymphoplasmacytic infiltrate with abundant IgG4‐positive plasma cells and fibrosis. Differentiating between cholangiocarcinoma and IgG4‐sclerosing cholangitis can present a diagnostic dilemma. We describe an unusual presentation of a hepatic mass meeting multiple criteria for IgG4‐sclerosing cholangitis but was ultimately found to be cholangiocarcinoma. Several published case reports describe patients with suspected cholangiocarcinoma who are later found to have IgG4‐sclerosing cholangitis, but few reports have demonstrated the reverse. Distinguishing between cholangiocarcinoma and IgG4‐sclerosing cholangitis is challenging, and a high clinical suspicion for cholangiocarcinoma must always be maintained. (Hepatology Communications 2018;2:349‐353)

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“…used ≥50 IgG4 + plasma cells/HPF and an IgG4:IgG ratio greater than 50% in an attempt to reduce false‐positive diagnoses 51 . It should also be noted that some cancers may elicit a lymphoplasmacytic response enriched by IgG4 + plasma cells with associated fibrosis, and a multidisciplinary team approach is important to ensure that the correct diagnosis is established 56 …”

Section: Igg4‐related Oesophagitismentioning

confidence: 99%

Novel and rare forms of oesophagitis

Malone

Sheahan

2020

Histopathology

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Our understanding of inflammatory diseases of the gastrointestinal tract, including those of the oesophagus, has expanded in recent years. Once attributed almost exclusively to gastro‐oesophageal reflux disease or infection, it is now recognised that oesophagitis may occur due to a variety of distinct disease entities. Many of these conditions cause debilitating and persistent symptoms, impacting upon quality of life and necessitating ongoing surveillance and treatment. This review will consider the clinical, endoscopic and histopathological features of these novel and rare forms of oesophagitis.

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Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma

Cited by 22 publications

References 38 publications

Clinical practice guidelines for IgG4‐related sclerosing cholangitis

Clinical practice guidelines for IgG4‐related sclerosing cholangitis

Hilar cholangiocarcinoma associated with immunoglobulin G4‐positive plasma cells and elevated serum immunoglobulin G4 levels

Novel and rare forms of oesophagitis

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