Abstract
IgG4-related lung lesions are characterized by inflammatory cell infiltration and fibrosis occurring in the connective tissue (lymph tract) within the lung, mainly along the bronchovascular bundle, interlobular septa, and alveolar interstitium. As a result, diagnostic imaging studies often reveal ground-glass opacities and thickening of bronchovascular bundle and interlobular septa. In addition, some cases demonstrate mass lesions that must be differentiated from primary lung cancer.
Classification into four types on the basis of CT findings is possible: (1) solid, nodular lesions; (2) rounded ground-glass opacities (GGO); (3) alveolar-interstitial lesions; and (4) a bronchovascular pattern. Each of these types must be differentiated from other disorders that can present with similar radiologic findings. Comprehensive diagnosis must also consider the serum IgG4 concentration; the presence or absence of other organ involvement; and, whenever possible, the pulmonary histopathology.
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References
Taniguchi T, Ko M, Seko S, et al. Interstitial pneumonia associated with autoimmune pancreatitis. Gut. 2004;53:770.
Hirano K, Kawabe T, Komatsu Y, et al. High-rate pulmonary involvement in autoimmune pancreatitis. Intern Med. 2006;36:58–61.
Zen Y, Kitagawa S, Minato H, et al. IgG4-positive plasma cells in inflammatory pseudotumor (plasma cell granuloma) of the lung. Hum Pathol. 2005;36:710–7.
Hamed G, Tsushima K, Yasuo M, et al. Inflammatory lesions of the lung, submandibular gland, bile duct and prostate in a patient with IgG4-associated multifocal systemic fibrosclerosis. Respirology. 2007;12:455–7.
Matsui S, Taki H, Shinoda K, et al. Respiratory involvement in IgG4-related Mikulicz’s disease. Mod Rheumatol. 2011;22:31–9.
Duvic C, Desrame J, Lévêque C, Nedelec G. Retroperitoneal fibrosis, sclerosing pancreatitis and bronchiolitis obliterans with organizing pneumonia. Nephrol Dial Transplant. 2004;19:2397–9.
Kobayashi H, Shimokawaji T, Kanoh S, et al. IgG4-positive pulmonary disease. J Thorac Imaging. 2007;22:360–2.
Ryu JH, Sekiguchi H, Yi ES. Pulmonary manifestations of IgG4-related sclerosing disease. Eur Respir J. 2012;39(1):180–6.
Inoue D, Zen Y, Abo H, et al. Immunoglobulin G4-related lung disease: CT findings with pathologic correlations. Radiology. 2009;251(1):260–70.
Zen Y, Inoue D, Kitao A, et al. IgG4-related lung and pleural disease: a clinicopathologic study of 21 cases. Am J Surg Pathol. 2009;33(12):1886–93.
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Inoue, D., Zen, Y., Matsui, S., Waseda, Y., Matsui, O., Gabata, T. (2014). Lung Lesions. In: Umehara, H., Okazaki, K., Stone, J., Kawa, S., Kawano, M. (eds) IgG4-Related Disease. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54228-5_14
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DOI: https://doi.org/10.1007/978-4-431-54228-5_14
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