IgG4-related sclerosing cholangitis can cause a variety of patterns on cholangiography.
Analysis: cholangiography
Key Findings |
Type |
stenosis only in the distal common bile duct |
1 |
diffuse stenosis of intra- and extrahepatic bile ducts with prestenotic dilation of intrahepatic bile ducts |
2a |
diffuse stenosis of intra- and extrahepatic bile ducts without prestenotic dilation of intrahepatic bile ducts |
2b |
stenosis in the hilar region and in distal common bile duct |
3 |
stenosis only in the hilar region |
4 |
where:
• Type 3 is combination of Types 1 and 4
Bile Duct Changes |
Type |
dilatation of the intra- and extra-hepatic bile ducts |
1 |
narrowing of intrahepatic bile ducts; extrahepatic bile duct may be distended with stenosis of distal common bile duct |
2a |
narrowing of intrahepatic bile ducts with reduced bile duct branches; extrahepatic bile duct may be distended with stenosis of distal common bile duct |
2b |
stenosis in the hilar region and in distal common bile duct |
3 |
stenosis only in the hilar region |
4 |
Differential diagnosis:
(1) cholangiocarcinoma (Types 1, 3, and 4)
(2) pancreatic cancer (Type 1)
(3) primary sclerosing cholangitis (Type 2)
Specialty: Gastroenterology, Immunology/Rheumatology