A Case of Immunoglobulin G4-related Lymphadenopathy Associated with Rectal Cancer

Koumo, Toshiaki; Maeda, Yoshiyuki; Nagatani, Satoru; Tahara, Ko; Hotei, Hiroshi; Sasaki, Nozomu

doi:10.3919/jjsa.74.2817

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…To our knowledge, there are only 4 case reports of rectal cancer associated to IgG4-RD. [ 15 – 18 ] All were elderly Asian patients (aged between 66 and 72 years) with high serum IgG4 levels. None of these cases had orbital involvement of IgG4-RD, which makes the present case exceptional.…”

Section: Discussionmentioning

confidence: 99%

Colon cancer and IgG4-related disease with orbital inflammation and bilateral optic perineuritis

Lemaître

Esquerda²,

Guardiola

et al. 2018

Medicine

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Rationale:Immunoglobulin G4-related disease (IgG4-RD) is an inflammatory condition of unknown cause. Cancer might be related to the development of certain IgG4-RD but to date, little literature documents it.Patient concerns:A 78-year old man presented with unilateral proptosis responsive to steroids, initially attributed to nonspecific orbital inflammation.Diagnosis:Right hemicolectomy was performed because of a suspicious lesion which turned out to be tubulovillous adenoma on histological analysis. Eight months after the surgery, a mass infiltrating the mesentery was found and biopsy revealed IgG4-RD.Interventions:Both the orbital inflammation and abdominal mass infiltrating the mesentery were responsive to steroids and rituximab administered to treat IgG4-RD.Outcomes:In the course of IgG4-RD, the patient developed bilateral optic perineuritis, causing bilateral visual loss. Colon cancer with synchronous multiple liver metastases was found 1 year after rituximab treatment.Lessons:This case raises the possibility of IgG4-RD being a paraneoplastic syndrome in some patients. Cancer screening should probably be performed in some elderly patients diagnosed with IgG4-RD.

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Section: Discussionmentioning

confidence: 99%

Colon cancer and IgG4-related disease with orbital inflammation and bilateral optic perineuritis

Lemaître

Esquerda²,

Guardiola

et al. 2018

Medicine

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“…The incidence of malignant tumor in patient of autoimmune pancreatitis was nearly three times higher than in normal population [ 2 ]. Only two cases of rectal cancer with IgG4-related disease were previously reported in the literature [ 13 , 14 ]. In those cases, no infiltration of IgG4-positive plasma cells was seen in and around the rectal cancer.…”

Section: Case Presentationmentioning

confidence: 99%

A case of IgG4-related disease coexisted with rectal cancer

et al. 2015

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A 67-year-old man was referred to our hospital with suspicion of rectal tumor, hilar tumor, and urinary tumor. Colonoscopic findings were intermittent nodular lesions with redness which were atypical to primary rectal cancer. Endoscopic retrograde cholangiopancreatography showed narrowing of the bilateral intrahepatic bile duct. However, the findings were improved 1 month later. Blood biochemistry showed high level of serum IgG4 up to 1140 mg/dl. The patient matched to comprehensive diagnostic criteria for IgG4-related disease as a possible diagnostic case. Laparoscopic low anterior resection with creation of ileostomy was performed for rectal cancer. Histological findings revealed cancer cells spread horizontally at submucosal layer and subserosal layer. There was marked infiltration of the plasma cells and lymphocytes at tumor stroma, and more than half of the plasma cells were positive for IgG4. After surgery, the level of serum IgG4 was decreased to 597 mg/dl. Although the association with IgG4-related disease and colorectal disease is unclear, the tumor progression was atypical for rectal cancer. Some report that the disease may rise up the risk of a malignant disease. It is necessary to perform systemic examination keeping in mind for concurrence of malignancy.

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A Case of Immunoglobulin G4-related Lymphadenopathy Associated with Rectal Cancer

Cited by 2 publications

References 9 publications

Colon cancer and IgG4-related disease with orbital inflammation and bilateral optic perineuritis

Colon cancer and IgG4-related disease with orbital inflammation and bilateral optic perineuritis

A case of IgG4-related disease coexisted with rectal cancer

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