A case of IgG4-related disease presenting with right pleural effusion and a pulmonary nodule with low density area
Hayato Yabea Motoki Natsuizakaa Hidetaka Yajimab Toshinori Matsuic Kiyoshi Kasaid
aDepartment of Respiratory Medicine, Otaru General Hospital
bDepartment of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine
cDepartment of Otorhinolaryngology, Otaru General Hospital
dDepartment of Pathology, Otaru General Hospital
A 79-year-old man was referred to our hospital for detailed examination of right pleural effusion. He was asymptomatic, but physical examination revealed swelling of the right parotid gland. Pleural effusion was exudative with lymphoplasmacytic predominance. A chest computed tomography taken after drainage of pleural effusion showed swelling of mediastinal lymph nodes, a consolidation in the left lower lobe, and a nodule with a low density area in the right lower lobe. Biopsy specimens obtained from a right lower nodule and the right parotid gland showed IgG4-positive lymphoplasmacytic infiltration. Thus IgG4-related disease was diagnosed, and systemic corticosteroid therapy was commenced. Then thoracic lesions and the right parotid gland swelling were resolved, and his corticosteroid dose was tapered. To our knowledge, this appears to be the first case report of IgG4-related disease presenting with pleural effusion and a pulmonary nodule with a low density area.
IgG4-related disease IgG4-related respiratory disease Multicentric Castleman's disease Pleural effusion
Received 30 Jun 2015 / Accepted 13 Nov 2015
AJRS, 5(2): 90-95, 2016