PMC10371806_01
H&E, X 200: The liver core biopsy revealed moderate centrilobular, intra-sinusoidal and portal/periportal inflammatory infiltrate comprised predominantly of plasma cells.
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Patchy minimal portal vein endotheliitis was seen (Fig. 1).
CD 138, X 400: Immunohistochemical stain for CD138 highlights the plasma cell population.
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IgG4 highlighted upto 35 plasma cells per high power field at the hot spots in portal tracts (Fig. 2, Fig. 3).
Kappa, X 400: Immunohistochemical staining reveal atypical kappa, predominant plasma cells (kappa to lambda ratio of 8-10:1).
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IgG4/ IgG ratio is approximately 30%. Immunohistochemistry showed atypical kappa predominant plasma cells (Fig. 4).