A case of IgG4-related disease with multiple endobronchial nodular lesions
Yuko Katayama Toshikatsu Sado Yumi Nishihara Kazuya Tanimura Yukimasa Hatachi Hideo Kita
Department of Respiratory Medicine, Takatsuki Red Cross Hospital
A 68-year-old man complaining of cough with abnormal chest CT findings was admitted to our hospital in January 2011. The chest CT showed multiple bilateral ground glass opacities and nodular lesions in the lungs. Also shown were lymphadenopathy of the hilum and mediastinum. The patient had a tumor of the left submandibular gland, and a histopathologic examination of a left submandibular gland biopsy revealed infiltration of IgG4-positive plasma cells. We diagnosed chronic sclerosing sialadenitis. Surgical lung biopsy further revealed infiltration of IgG4-positive plasma cells in the lung lesions. Bronchoscopy was performed, and we observed multiple small nodules in the endobronchial mucosa. These lesions were diagnosed as IgG4-related chronic sclerosing sialadenitis and IgG4-related lung disease. After treatment with prednisolone 30 mg/day, his symptoms improved rapidly, and the lesions improved remarkably. Although endobronchial lesions in IgG4-related disease have been previously reported, multiple small nodules such as those seen in this case have not been described.
IgG4-related disease Chronic sclerosing sialadenitis Interstitial pneumonia Endobronchial lesion
Received 15 Feb 2012 / Accepted 18 May 2012
AJRS, 1(7): 614-617, 2012