Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis
Since autoimmune pancreatitis (AIP) was established as a new disease entity, sclerosing change with abundant immunoglobulin-4 (IgG4)-positive plasma cells, storiform fibrosis, and obliterative phlebitis are main pathological features in IgG4-related diseases. Regarding IgG4-related sclerosing cholec...
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MDPI AG
2021-07-01
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author | Masaki Kuwatani Naoya Sakamoto |
author_facet | Masaki Kuwatani Naoya Sakamoto |
author_sort | Masaki Kuwatani |
collection | DOAJ |
description | Since autoimmune pancreatitis (AIP) was established as a new disease entity, sclerosing change with abundant immunoglobulin-4 (IgG4)-positive plasma cells, storiform fibrosis, and obliterative phlebitis are main pathological features in IgG4-related diseases. Regarding IgG4-related sclerosing cholecystitis (IgG4-CC), which is occasionally associated with AIP cases and is rarely isolated, there are no diagnostic criteria and insufficient perceptions of the image findings. Although there have been some reports on IgG4-CC, differentiation between IgG4-CC and gallbladder cancer is very difficult in some cases with a localized lesion. In this review, we especially focused on image findings of IgG4-CC and summarized its image features for diagnostic assistance. The ultrasonography and CT findings of IgG4-CC could be classified into diffuse and localized types. Based on these findings, the presence of wall thickening with an intact or smooth mucosal layer, followed by a homogenously thickened outer layer, would be a helpful morphological finding to distinguish IgG4-CC from gallbladder cancer. |
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spelling | doaj.art-45eaba47a46a4bb89cf50ea5de4a9ba42023-11-22T07:19:21ZengMDPI AGDiagnostics2075-44182021-07-01118135810.3390/diagnostics11081358Clinical and Image Characteristics of IgG4-Related Sclerosing CholecystitisMasaki Kuwatani0Naoya Sakamoto1Department of Gastroenterology and Hepatology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo 060-8648, JapanDepartment of Gastroenterology and Hepatology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo 060-8648, JapanSince autoimmune pancreatitis (AIP) was established as a new disease entity, sclerosing change with abundant immunoglobulin-4 (IgG4)-positive plasma cells, storiform fibrosis, and obliterative phlebitis are main pathological features in IgG4-related diseases. Regarding IgG4-related sclerosing cholecystitis (IgG4-CC), which is occasionally associated with AIP cases and is rarely isolated, there are no diagnostic criteria and insufficient perceptions of the image findings. Although there have been some reports on IgG4-CC, differentiation between IgG4-CC and gallbladder cancer is very difficult in some cases with a localized lesion. In this review, we especially focused on image findings of IgG4-CC and summarized its image features for diagnostic assistance. The ultrasonography and CT findings of IgG4-CC could be classified into diffuse and localized types. Based on these findings, the presence of wall thickening with an intact or smooth mucosal layer, followed by a homogenously thickened outer layer, would be a helpful morphological finding to distinguish IgG4-CC from gallbladder cancer.https://www.mdpi.com/2075-4418/11/8/1358IgG4sclerosingcholecystitisgallbladderultrasonography |
spellingShingle | Masaki Kuwatani Naoya Sakamoto Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis Diagnostics IgG4 sclerosing cholecystitis gallbladder ultrasonography |
title | Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis |
title_full | Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis |
title_fullStr | Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis |
title_full_unstemmed | Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis |
title_short | Clinical and Image Characteristics of IgG4-Related Sclerosing Cholecystitis |
title_sort | clinical and image characteristics of igg4 related sclerosing cholecystitis |
topic | IgG4 sclerosing cholecystitis gallbladder ultrasonography |
url | https://www.mdpi.com/2075-4418/11/8/1358 |
work_keys_str_mv | AT masakikuwatani clinicalandimagecharacteristicsofigg4relatedsclerosingcholecystitis AT naoyasakamoto clinicalandimagecharacteristicsofigg4relatedsclerosingcholecystitis |