A case of the hepatopathy developed prior to IgG4 related autoimmune pancreatitis

We report a case of IgG4-related liver disease. A woman in her 60s was admitted in our hospital, and was diagnosed with malignant liver tumor and gastric cancer. The liver mass was resected and histological examination revealed that infiltration of inflammatory cells, lymphoid follicles, and fibrosis were seen in portal tract. Many portal veins were narrowing and obstructed, and obstructive phlebitis was seen in central veins. IgG4-positive plasma cells were seen less than 25 per high power field, and the ratio of IgG4/IgG positive plasma cell was less than 20%. About a year later she developed autoimmune pancreatitis, therefore former hepatic lesion was thought to be IgG4-related disease, especially IgG4 hepatopathy. This is the first report, which found that IgG4 hepatopathy was developed prior to autoimmune pancreatitis.