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

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

doi:10.1016/j.dld.2013.03.007

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

Standard

Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma. / Resheq, Yazid J; Quaas, Alexander; von Renteln, Daniel; Schramm, Christoph ; Lohse, Ansgar W; Lüth, Stefan.

in: DIGEST LIVER DIS, Jahrgang 45, Nr. 10, 01.10.2013, S. 859-65.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Resheq, YJ, Quaas, A, von Renteln, D, Schramm, C , Lohse, AW & Lüth, S 2013, 'Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma', DIGEST LIVER DIS, Jg. 45, Nr. 10, S. 859-65. https://doi.org/10.1016/j.dld.2013.03.007

APA

Resheq, Y. J., Quaas, A., von Renteln, D., Schramm, C., Lohse, A. W., & Lüth, S. (2013). Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma. DIGEST LIVER DIS, 45(10), 859-65. https://doi.org/10.1016/j.dld.2013.03.007

Vancouver

Resheq YJ, Quaas A, von Renteln D, Schramm C , Lohse AW, Lüth S. Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma. DIGEST LIVER DIS. 2013 Okt 1;45(10):859-65. https://doi.org/10.1016/j.dld.2013.03.007

Bibtex

@article{fa0319c925cd4565a74a038132713ab7,

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

abstract = "BACKGROUND: Recently, new guidelines for diagnosing IgG4-associated cholangitis have been published devaluing the diagnostic significance of IgG4-positive plasma cells and steroid trials. We sought to evaluate the utility of IgG4-positive plasma cells in discriminating IgG4-associated cholangitis from hilar cholangiocarcinoma and autoimmune pancreatitis from pancreatic adenocarcinoma under conditions when malignancy is likely to be missed.METHODS: Resection specimens obtained from patients with hilar cholangiocarcinoma, pancreatic adenocarcinoma or hepatocellular carcinoma were re-evaluated for IgG4-positivity. Histological analysis focussed on peritumoural but tumour-free sections. Perioperative biochemical and clinical data were reviewed.RESULTS: Nineteen patients with hilar cholangiocarcinoma and 29 patients with pancreatic adenocarcinoma were eligible for histological re-evaluation. Six of 19 (32%) patients with hilar cholangiocarcinoma and 5 of 29 (17%) patients with pancreatic adenocarcinoma were IgG4-positive (≥20 IgG4-positive plasma cells per high power field). Patients with IgG4-positive hilar cholangiocarcinoma showed significantly higher levels of serum total bilirubin (3.6mg/dl vs. 1.8mg/dl; P<0.05) and serum alanine-aminotransferase (median 343U/l vs. 63U/l, P<0.05) compared to IgG4-negative patients with hilar cholangiocarcinoma.CONCLUSIONS: IgG4-positive plasma cells are of limited utility especially in distinguishing hilar cholangiocarcinoma from IgG4-associated cholangitis even when combined with clinical parameters and may be misleading under conditions when malignancy is missed.",

keywords = "Adenocarcinoma, Aged, Alanine Transaminase, Autoimmune Diseases, Bile Duct Neoplasms, Bile Ducts, Intrahepatic, Bilirubin, Cholangiocarcinoma, Cholangitis, Diagnosis, Differential, Female, Humans, Immunoglobulin G, Male, Middle Aged, Pancreas, Pancreatic Neoplasms, Pancreatitis, Plasma Cells",

author = "Resheq, {Yazid J} and Alexander Quaas and {von Renteln}, Daniel and Christoph Schramm and Lohse, {Ansgar W} and Stefan L{\"u}th",

year = "2013",

month = oct,

day = "1",

doi = "10.1016/j.dld.2013.03.007",

language = "English",

volume = "45",

pages = "859--65",

journal = "DIGEST LIVER DIS",

issn = "1590-8658",

publisher = "Elsevier",

number = "10",

}

RIS

TY - JOUR

T1 - Infiltration of peritumoural but tumour-free parenchyma with IgG4-positive plasma cells in hilar cholangiocarcinoma and pancreatic adenocarcinoma

AU - Resheq, Yazid J

AU - Quaas, Alexander

AU - von Renteln, Daniel

AU - Schramm, Christoph

AU - Lohse, Ansgar W

AU - Lüth, Stefan

PY - 2013/10/1

Y1 - 2013/10/1

N2 - BACKGROUND: Recently, new guidelines for diagnosing IgG4-associated cholangitis have been published devaluing the diagnostic significance of IgG4-positive plasma cells and steroid trials. We sought to evaluate the utility of IgG4-positive plasma cells in discriminating IgG4-associated cholangitis from hilar cholangiocarcinoma and autoimmune pancreatitis from pancreatic adenocarcinoma under conditions when malignancy is likely to be missed.METHODS: Resection specimens obtained from patients with hilar cholangiocarcinoma, pancreatic adenocarcinoma or hepatocellular carcinoma were re-evaluated for IgG4-positivity. Histological analysis focussed on peritumoural but tumour-free sections. Perioperative biochemical and clinical data were reviewed.RESULTS: Nineteen patients with hilar cholangiocarcinoma and 29 patients with pancreatic adenocarcinoma were eligible for histological re-evaluation. Six of 19 (32%) patients with hilar cholangiocarcinoma and 5 of 29 (17%) patients with pancreatic adenocarcinoma were IgG4-positive (≥20 IgG4-positive plasma cells per high power field). Patients with IgG4-positive hilar cholangiocarcinoma showed significantly higher levels of serum total bilirubin (3.6mg/dl vs. 1.8mg/dl; P<0.05) and serum alanine-aminotransferase (median 343U/l vs. 63U/l, P<0.05) compared to IgG4-negative patients with hilar cholangiocarcinoma.CONCLUSIONS: IgG4-positive plasma cells are of limited utility especially in distinguishing hilar cholangiocarcinoma from IgG4-associated cholangitis even when combined with clinical parameters and may be misleading under conditions when malignancy is missed.

AB - BACKGROUND: Recently, new guidelines for diagnosing IgG4-associated cholangitis have been published devaluing the diagnostic significance of IgG4-positive plasma cells and steroid trials. We sought to evaluate the utility of IgG4-positive plasma cells in discriminating IgG4-associated cholangitis from hilar cholangiocarcinoma and autoimmune pancreatitis from pancreatic adenocarcinoma under conditions when malignancy is likely to be missed.METHODS: Resection specimens obtained from patients with hilar cholangiocarcinoma, pancreatic adenocarcinoma or hepatocellular carcinoma were re-evaluated for IgG4-positivity. Histological analysis focussed on peritumoural but tumour-free sections. Perioperative biochemical and clinical data were reviewed.RESULTS: Nineteen patients with hilar cholangiocarcinoma and 29 patients with pancreatic adenocarcinoma were eligible for histological re-evaluation. Six of 19 (32%) patients with hilar cholangiocarcinoma and 5 of 29 (17%) patients with pancreatic adenocarcinoma were IgG4-positive (≥20 IgG4-positive plasma cells per high power field). Patients with IgG4-positive hilar cholangiocarcinoma showed significantly higher levels of serum total bilirubin (3.6mg/dl vs. 1.8mg/dl; P<0.05) and serum alanine-aminotransferase (median 343U/l vs. 63U/l, P<0.05) compared to IgG4-negative patients with hilar cholangiocarcinoma.CONCLUSIONS: IgG4-positive plasma cells are of limited utility especially in distinguishing hilar cholangiocarcinoma from IgG4-associated cholangitis even when combined with clinical parameters and may be misleading under conditions when malignancy is missed.

KW - Adenocarcinoma

KW - Aged

KW - Alanine Transaminase

KW - Autoimmune Diseases

KW - Bile Duct Neoplasms

KW - Bile Ducts, Intrahepatic

KW - Bilirubin

KW - Cholangiocarcinoma

KW - Cholangitis

KW - Diagnosis, Differential

KW - Female

KW - Humans

KW - Immunoglobulin G

KW - Male

KW - Middle Aged

KW - Pancreas

KW - Pancreatic Neoplasms

KW - Pancreatitis

KW - Plasma Cells

U2 - 10.1016/j.dld.2013.03.007

DO - 10.1016/j.dld.2013.03.007

M3 - SCORING: Journal article

C2 - 23602806

VL - 45

SP - 859

EP - 865

JO - DIGEST LIVER DIS

JF - DIGEST LIVER DIS

SN - 1590-8658

IS - 10

ER -