Abstract:
A 60-year-old female with a BRCA2 mutation and a history of breast cancer presented with diffuse abdominal pain and elevated liver enzymes. Imaging revealed a porta-hepatis mass, prompting consideration of hilar cholangiocarcinoma or breast cancer metastasis. Further investigation including biopsy and 18F-fluorodeoxyglucose positron emission tomography/computed tomography findings were inconsistent with malignancy, leading to investigation of non-neoplastic causes. Elevated IgG4 levels suggested IgG4-related disease, a mass-forming fibroinflammatory condition. This case demonstrates IgG4-related disease exclusively impacting the portal vein and underscores the importance of considering IgG4-related disease in the differential diagnosis of hepatic masses.
摘要:
一名60岁女性,有BRCA2突变和乳腺癌病史,表现为弥漫性腹痛和肝酶升高。成像显示肝门肿块,提示考虑肝门部胆管癌或乳腺癌转移。进一步的检查包括活检和18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描结果与恶性肿瘤不一致,导致非肿瘤原因的调查。IgG4水平升高提示IgG4相关疾病,一种肿块形成的纤维炎症。该病例表明IgG4相关疾病仅影响门静脉,并强调了在肝脏肿块的鉴别诊断中考虑IgG4相关疾病的重要性。