Immunoglobulin G4 Sclerosing Cholangitis: An Unusual Cause of Obstructive Jaundice—Case Report and Literature Review

Figure 3

Chromogenic in situ hybridization showing a mixture of kappa-bearing plasma (a) and lambda-bearing plasma (b) cells, with an approximate kappa to lambda ratio of 3–4 to 1, appropriate for a physiologic/reactive phenomenon, without evidence of obvious restriction. Plasma cells expressed predominantly IgG (c); of these, the majority (over 60%) were immunoreactive for IgG4 (d) (200x original magnification).

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