J Korean Soc Radiol.  2013 Jul;69(1):53-56. 10.3348/jksr.2013.69.1.53.

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

• Kwon SH
• Lee YK
• Shim MS
• Lee HI

• KMID: 2002890
• DOI: http://doi.org/10.3348/jksr.2013.69.1.53

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.

MeSH Terms

Immunoglobulin G
Immunoglobulins
Inflammation
Lung
Lung Neoplasms
Positron-Emission Tomography and Computed Tomography
Thorax
Immunoglobulin G
Immunoglobulins

Figure

• 

  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

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