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Immunohistochemical Study for IgG4-positive Plasmacytes in Pituitary Inflammatory Lesions

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Abstract

On histology, IgG4-related hypophysitis is essentially similar to lymphocytic hypophysitis besides massive IgG4-positive plasmacyte infiltration. This immunohistochemical study was performed to investigate the presence of IgG4-positive plasmacytes in 14 various inflammatory lesions. Five cases of lymphocytic hypophysitis and a case of granulomatous hypophysitis were either negative or showed only a few IgG4-postive cells. A case of hypophysitis associated with pachymeningitis and a case of pituitary invasion of lymphoma were IgG4 negative. On the other hand, some IgG4-positive cells that tended to accumulate were observed in every six cases of secondary inflammation. In conclusion, immunohistochemistry for IgG4 can be a clue for differentiating IgG4-related hypophysitis from lymphocytic hypophysitis. However, clusters of IgG4-positive plasmacytes could be observed in secondary inflammation. Diagnosing hypophysitis with small biopsy specimen still remains troublesome.

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Acknowledgment

We declare that we have no conflict of interest that could be perceived as prejudicing the impartiality of the research reported. We did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector. We are grateful to Prof. J. Patrick Barron of the Department of International Medical Communications of Tokyo Medical University for the review of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan

    Hiroshi Nishioka & Jo Haraoka

  2. Department of Diagnostic Pathology, Ibaraki Medical Center, Tokyo Medical University, Tokyo, Japan

    Makoto Shibuya

  3. Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1058470, Japan

    Hiroshi Nishioka

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  1. Hiroshi Nishioka
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  2. Makoto Shibuya
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  3. Jo Haraoka
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Correspondence to Hiroshi Nishioka.

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Nishioka, H., Shibuya, M. & Haraoka, J. Immunohistochemical Study for IgG4-positive Plasmacytes in Pituitary Inflammatory Lesions. Endocr Pathol 21, 236–241 (2010). https://doi.org/10.1007/s12022-010-9128-5

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