IgG4-related Sclerosing Cholangitis Complicated with Cholangiocarcinoma and Detected by Forkhead Box P3 Immunohistochemical Staining

An 80-year-old man was admitted due to biliary stricture with autoimmune pancreatitis. Although radiographical examinations suggested Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC), punched biopsies from the bile duct revealed adenocarcinoma. In the resected specimen, abundant N-terminus...

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Bibliographic Details
Published in:Internal Medicine 2021/03/15, Vol.60(6), pp.859-866
Main Authors: Toyohara, Tadashi, Nakazawa, Takahiro, Zakharia, Kais, Shimizu, Shuya, Miyabe, Katsuyuki, Harada, Kenichi, Notohara, Kenji, Yamada, Tomohiro, Hayashi, Katsumi, Naitoh, Itaru, Hayashi, Kazuki, Kataoka, Hiromi
Format: Article
Language:English
Subjects:
Adenocarcinoma
Aged, 80 and over
Autoimmune Diseases - diagnosis
autoimmune pancreatitis
Bile
Bile Duct Neoplasms - complications
Bile Duct Neoplasms - diagnosis
Bile ducts
Bile Ducts, Intrahepatic
Case Report
Cholangiocarcinoma
Cholangiocarcinoma - complications
Cholangiocarcinoma - diagnosis
Cholangitis
Cholangitis, Sclerosing - complications
Cholangitis, Sclerosing - diagnosis
Diagnosis, Differential
forkhead box P3
Forkhead protein
Foxp3 protein
Humans
Immunoglobulin G
Immunoglobulin G4
immunoglobulin G4-related disease
immunoglobulin G4-related sclerosing cholangitis
Internal medicine
Male
N-Terminus
Pancreatitis
Staining and Labeling
Stricture
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Description
Summary:An 80-year-old man was admitted due to biliary stricture with autoimmune pancreatitis. Although radiographical examinations suggested Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC), punched biopsies from the bile duct revealed adenocarcinoma. In the resected specimen, abundant N-terminus of Forkhead box P3 (Foxp3)-positive cells were localized in cholangiocarcinoma (CCA) tissue, while IgG4-positive cells were spread around the entire bile duct. Therefore, the case was diagnosed with IgG4-SC accompanied by CCA, not sporadic CCA. We herein report an informative case wherein IgG4-positive cells were abundant in CCA tissue and Foxp3 immunohistochemical staining allowed us to determine that this case had two entities.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.5920-20