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Abstract

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Article in Japanese

Case Report

A case of IgG4-related pulmonary disease heterochronically showing pulmonary inflammatory pseudotumor and interstitial pneumonia

Yuriko Tokudaa  Sadatomo Tasakaa  Katsuhiko Naokia  Yuichiro Hayashib  Koichiro Asanoc  Tomoko Betsuyakua 

aDivision of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine
bDivision of Diagnostic Pathology, Keio University School of Medicine
cDivision of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine

ABSTRACT

A 68-year old man was referred for the evaluation of pulmonary nodules. Histological examination of the nodules showed granuloma with lymphocytic infiltration. Three months later, the nodules spontaneously disappeared; however, within one month he developed shortness of breath, dry cough, and hypoxemia. Ground-glass opacities in both lower-lung fields emerged on chest radiograph, and serum IgG4 levels were notably increased. He was diagnosed as having IgG4-related (sclerosing) disease because of the infiltration of IgG4 positive plasma cells in the inguinal lymph node. The patient was treated with systemic prednisolone, showing rapid improvement. The IgG4-related disease can present heterochronic appearance of pulmonary nodules (inflammatory pseudotumor) and interstitial pneumonia.

KEYWORDS

Inflammatory pseudotumor  Interstitial pneumonia  Hilar lymphadenopathy  IgG4-related sclerosing disease 

Received 25 Sep 2012 / Accepted 25 Dec 2012

AJRS, 2(3): 311-315, 2013

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