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Article in Japanese
Abstract
Case Report
Inflammatory mediastinal mass accompanied with a high serum IgG4 level and a limited granulomatous vasculitis
Motoko Nomuraa Yasutaka Watanabea Shunsuke Endob Mitsuhiro Nokubic Yoshinori Kawabatad Shinichiro Koyamaa
aDivision of Pulmonary Medicine, Saitama Medical Center, Jichi Medical University
bDivision of Thoracic Surgery, Saitama Medical Center, Jichi Medical University
cDivision of Pathology, Saitama Medical Center, Jichi Medical University
dDivision of Pathology, Saitama Cardiovascular and Respiratory Center
ABSTRACT
A 67-year-old man was presented with dyspnea and hoarseness. Chest CT showed a right upper mediastinal mass at the level of the aortic arch. Pathological findings obtained from the surgical biopsy revealed necrotizing granulomatous inflammation without caseation, inflammatory cellular infiltration of histiocyte and multinucleated giant cell, and vasculitis of middle and small arteries in his lung. There was an infiltration of IgG4-positive plasma cells accompanied by elevation of serum IgG4 level. His symptoms and the mediastinal mass successfully improved after prednisolone therapy. This is an important case in which to consider the overlap or differential diagnosis of IgG4-related disease, fibrosing mediastinitis, and granulomatosis with polyangiitis.
KEYWORDS
Fibrous mediastinitis Granulomatosis with polyangiitis IgG4-related disease
Received 23 Jul 2015 ／ Accepted 1 Oct 2015
AJRS, 5(1): 23-27, 2016
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