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Kwon, Lee, Shim, and Lee: A Case of Immunoglobulin G4-Related Sclerosing Disease Mimicking Lung Cancer
Chest Radiology

Journal of the Korean Society of Radiology 2013; 69(1): 53-56.

Published online: 12 July 2013

DOI: https://doi.org/10.3348/jksr.2013.69.1.53

A Case of Immunoglobulin G4-Related Sclerosing Disease Mimicking Lung Cancer

Soo Hee Kwon, MD1, Young Kyung Lee, MD1, Mi-Suk Shim, MD1, Hyang Im Lee, MD2

1Department of Radiology, Seoul Medical Center, Seoul, Korea.

2Department of Pathology, Seoul Medical Center, Seoul, Korea.

Corresponding author: Young Kyung Lee, MD. Department of Radiology, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul 131-865, Korea. Tel. 82-2-2276-7000, Fax. 82-2-2276-7093, ykradio@medimail.co.kr

Received 23 January 2013       Accepted 30 April 2013

Copyright © 2013 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Immunoglobulin (Ig) G4-related sclerosing disease is a recently described systemic fibro-inflammatory disease associated with an elevated circulating level of IgG4 and extensive IgG4-positive lymphoplasmacytic infiltration, resulting in sclerosing inflammation involving various body organs. We experienced one case where surgery confirmed IgG4-related sclerosing disease as a solitary lung mass mimicking lung cancer. We report radiologic findings including chest computed tomography and positron emission tomography computed tomography, with clinical manifestations of IgG4-related sclerosing disease.

Keywords: Lung, Immunoglobulin G4, Sclerosing Disease

Figures and Tables

Fig. 1
A 68-year-old woman with immunoglobulin (Ig) G4-related sclerosing disease.
A. A thoraco-lumbar spine film shows no parenchymal lesion in the scanned lung at 2 months before admission.
B. Initial chest PA shows a round solitary pulmonary mass (arrows) at right lower lung zone.
C. A postcontrast axial CT shows relatively homogenous enhancing mass (arrow) in posterior basal segment of right lower lung.
D. A PET CT axial image shows strongly increased 18F-fluorodeoxyglucose uptake (SUV max = 9) (arrow) in the mass like lesion of right lower lung.
E. Photomicrograph of histopathological specimen shows IgG4-positive plasma cells in the resected lung (up to 20/HPF; immunohistochemical staining, × 400).
Note.-HPF = high power field, PA = posteroanterior, PET CT = positron emission tomography CT, SUV = standardized uptake value
jksr-69-53-g001

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