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Abstract

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Article in Japanese

Case Report

A case of IgG4-related respiratory disease radiologically mimicking chronic lower respiratory tract infection diagnosed by transbronchial lung cryobiopsy

Suzuka Matsuoka  Keiichi Fujiwara  Takeru Ichikawa  Hiroki Omori  Eri Nakamura  Miho Fujiwara 

Department of Respiratory Medicine, National Hospital Organization Okayama Medical Center

ABSTRACT

A 78-year-old man visited a nearby hospital in January 2019 because of anorexia and weight loss. Chest computed tomography (CT) scan showed ground glass opacity and centrilobular nodules; chronic lower respiratory tract infection was therefore considered. However, sputum examination and blood chemistry did not reveal a specific cause. Half a year later, chest CT scan showed spontaneous regression of lung abnormalities. Two years later, he noted a productive cough, and radiological findings on chest CT scan showed worsening of the shadow. A specimen obtained by transbronchial lung cryobiopsy (TBLC) revealed IgG4-related respiratory disease (IgG4-RRD) on pathological examination. IgG4-RRD has various radiological manifestations and as a result, diagnosis can be challenging. We should consider IgG4-RRD as a differential diagnosis when chronic lower respiratory tract infection is suspected based on clinical and imaging findings. In addition, TBLC may be a useful diagnostic approach for IgG4-RRD.

KEYWORDS

IgG4-related respiratory disease (IgG4-RRD)  Chronic lower respiratory tract infection  Bronchiolitis  Transbronchial lung cryobiopsy (TBLC) 

Received 29 Oct 2022 / Accepted 17 Jan 2023

AJRS, 12(3): 114-118, 2023

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