J Korean Soc Radiol.  2018 Nov;79(5):276-281. 10.3348/jksr.2018.79.5.276.

Sequential CT Findings in Two Cases of Immunoglobulin G4-Related Lung Disease: Focused on Disease Progression

Affiliations
  • 1Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
  • 2Department of Radiology, Kangbuk Samsung Hospital, Seoul, Korea. syohammd@hanmail.net

Abstract

Immunoglobulin G4 (IgG4)-related lung disease has been actively studied over the past few years. Radiologic findings of IgG4-related lung disease vary among patients, but there are no long-term follow up studies regarding variations in imaging features over the course of disease progression. In two cases with relatively long-term follow up, diverse early and late computed tomography (CT) findings of IgG4-related lung disease are reviewed in this report. In contrast to nodular or diffuse ground-glass opacity, which was predominantly noted in CT scans at earlier stages of disease, honeycombing and traction bronchiectasis were regarded as late radiologic manifestations. Solid nodules might be visible in both early and late stages; however, development of new solid nodules and enlargement of preexisting nodules could occur during disease progression. Interlobular septal thickening and mediastinal/hilar lymphadenopathy were persistent, even in later stages of the disease. These findings might be useful in making an accurate and timely diagnosis of IgG4-related lung disease.


MeSH Terms

Bronchiectasis
Diagnosis
Disease Progression*
Follow-Up Studies
Humans
Immunoglobulin G
Immunoglobulins*
Lung Diseases*
Lung*
Lymphatic Diseases
Tomography, X-Ray Computed
Traction
Immunoglobulin G
Immunoglobulins

Reference

1. Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol. 2012; 22:21–30.
Article
2. Hamano H, Kawa S, Horiuchi A, Unno H, Furuya N, Akamatsu T, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001; 344:732–738.
Article
3. Kamisawa T, Funata N, Hayashi Y, Eishi Y, Koike M, Tsuruta K, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol. 2003; 38:982–984.
Article
4. Matsui S, Hebisawa A, Sakai F, Yamamoto H, Terasaki Y, Kurihara Y, et al. Immunoglobulin G4-related lung disease: clinicoradiological and pathological features. Respirology. 2013; 18:480–487.
Article
5. Ryu JH, Sekiguchi H, Yi ES. Pulmonary manifestations of immunoglobulin G4-related sclerosing disease. Eur Respir J. 2012; 39:180–186.
Article
6. Inoue D, Zen Y, Abo H, Gabata T, Demachi H, Kobayashi T, et al. Immunoglobulin G4–related lung disease: CT findings with pathologic correlations. Radiology. 2009; 251:260–270.
Article
7. Yamamoto M, Takahashi H, Ishigami K, Yajima H, Shimizu Y, Tabeya T, et al. Relapse patterns in IgG4-related disease. Ann Rheum Dis. 2012; 71:1755.
8. Shimizu Y, Yamamoto M, Naishiro Y, Sudoh G, Ishigami K, Yajima H, et al. Necessity of early intervention for IgG4-related disease--delayed treatment induces fibrosis progression. Rheumatology (Oxford). 2013; 52:679–683.
Article
9. Kobayashi H, Shimokawaji T, Kanoh S, Motoyoshi K, Aida S. IgG4-positive pulmonary disease. J Thorac Imaging. 2007; 22:360–362.
Article
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