A case of immunoglobulin G4-related lung disease with cysts
Keitaro Nakamotoa Noboru Takayanagia Tsutomu Yanagisawaa Yoshihiko Shimizub Yoshinori Kawabatab Yutaka Sugitaa
aDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center
bDepartment of Pathology, Saitama Cardiovascular and Respiratory Center
A 39-year-old man was referred to our hospital because of cough and sputum production and an abnormal chest X-ray. Chest computed tomography (CT) showed some cysts, micronodules, nodules, ground glass opacity (GGO), and thickening of interlobular septa in the bilateral lungs. Laboratory tests showed elevated serum immunoglobulin G (IgG) and IgG4 levels. Transbronchial lung biopsy yielded no significant findings. A video-assisted thoracic surgery biopsy specimen from the right S6 showed cysts and infiltration of abundant IgG4-positive plasma cells. We diagnosed IgG4-related lung disease. This disease has recently been recognized. Nodules, GGO, and thickening of interlobular septa are frequent CT findings, but cysts are rare. For differential diagnosis of pulmonary disease when cysts are present on a chest CT, we must consider IgG4-related lung disease.
Cyst IgG4 IgG4-related lung disease
Received 18 Oct 2011 / Accepted 17 Feb 2012
AJRS, 1(6): 487-491, 2012