Comparison between sarcoidosis and IgG4-related disease by whole-body 67Ga scintigraphy

Ishii, Shiro; Miyajima, Masayuki; Sakuma, Kotaro; Kikuchi, Ken; Shishido, Fumio

doi:10.1097/mnm.0b013e32835a2eea

Cited by 11 publications

(13 citation statements)

References 37 publications

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“…A study of gallium scanning focused on comparison between sarcoidosis and IgG4 disease showed uptake in different patients at variable sites including mediastinal, hilar, supraclavicular, inguinal, submandibular and paraaortic lymph nodes, lacrimal and parotid glands, lung, heart, spleen, kidney, and pancreas. [12] IgG4-RSD showed uptake at various sites including hilar, paraaortic, and mediastinal lymph nodes, lacrimal, parotid, submandibular glands, lung, pancreas, and kidney. [12] Thus, the 2 entities showed overlapping regions of gallium uptake.…”

Section: Discussionmentioning

confidence: 99%

“…[12] IgG4-RSD showed uptake at various sites including hilar, paraaortic, and mediastinal lymph nodes, lacrimal, parotid, submandibular glands, lung, pancreas, and kidney. [12] Thus, the 2 entities showed overlapping regions of gallium uptake. Though in our case pathological studies were not done on all of the gallium-positive lesions, all of the gallium-avid lesions in our case showed complete remission after steroid treatment.…”

Section: Discussionmentioning

confidence: 99%

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Gallium SPECT/CT in evaluation of IgG4-related disease

Chuang

Hsu²,

Chi³

et al. 2016

Medicine

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Background:The clinical picture of IgG4-related sclerosing disease (IgG4-RSD) may mimic lymphoma, and should be in the differential diagnosis of patients with this clinical picture.Case summary:A 32-year-old female had recurrent swelling of both eyelids for more than 15 years. Examination revealed elastic, firm, swollen lacrimal glands about 2–3 cm in diameter that was not painful. Head and orbits magnetic resonance imaging (MRI) showed mass lesions over the bilateral lacrimal glands, submandibular glands, and left foramen of ovale. The differential diagnosis included lymphoid tissue, inflammatory masses, and lymphoma. Gallium single-photon emission computed tomography/computed tomography (SPECT/CT) showed uptake in the bilateral lacrimal glands, right parotid and bilateral submandibular glands, bilateral perirenal region, mediastinal, prevertebral, paraaortic, lumbar, bilateral pelvic (including internal iliac chain) lymph nodes, anterior aspect of right 3rd rib, and lateral aspect of left 6th rib. CT showed multiple enlarged lymph nodes in the mediastinum, right pulmonary hilum, prevertebral space of the thoracolumbar spine, retroperitoneal paraaortic area, bilateral parailiac areas, and bilateral perirenal spaces. Antinuclear and anti-SSA/SSB antibodies were negative, and the serum IgG4 level was 740 mg/dL (normal, 8–140 mg/dL). Right parotid gland biopsy showed abundant IgG4-positive plasma cells. Mikulicz disease (IgG4-related sclerosing disease) was diagnosed and she received glucocorticoid treatment. Follow-up CT and MRI showed with resolved eyelid swelling and perirenal mass lesions. Follow-up gallium scan was normal.Conclusion:Gallium SPECT/CT can be a useful tool for initial and follow-up evaluation of IgG4-RSD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gallium SPECT/CT in evaluation of IgG4-related disease

Chuang

Hsu²,

Chi³

et al. 2016

Medicine

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“…Uptake in the bilateral lacrimal glands on scintigraphy, the so-called "panda sign," is characteristic of patients with sarcoidosis 8,9) . Ishii et al 10) have reported a comparison between sarcoidosis and injection alone 6,7) . This patient received combination therapy with systemic steroids and intralesional steroid injection, because he had a prior history of systemic sarcoidosis and certain symptoms such as constriction of the visual field caused by the impairment of eye-opening, and extraocular symptoms including polyarthralgia.…”

Section: Discussionmentioning

confidence: 99%

“…related disease using 67 Ga scintigraphy10) ; abnormal uptake in the lacrimal glands was observed in 96% of patients with sarcoidosis, compared to 62% of patients with IgG 4 -related disease. Uptake in the mediastinal LNs, in the supraclavicular LNs, and in muscle is specific to sarcoidosis, while uptake in the pancreas and submandibular gland indicates IgG 4 -related disease.…”

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confidence: 95%

A case of lacrimal sarcoidosis following interstitial pneumonia: imaging and management

Kawashiri

Nakamura

Origuchi

et al. 2015

Jpn. J. Clin. Immunol.

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A 60-year-old Japanese man developed a fever and dry cough. Although chest CT showed interstitial pneumonia, the primary disease was not revealed. The interstitial pneumonia was improved by treatment with oral prednisolone following methylprednisolone pulse therapy. After the discontinuation of prednisolone he developed swelling of the eyelids and polyarthralgia. Orbital magnetic resonance imaging showed enlargement of the bilateral lacrimal glands. (67)Gallium scintigraphy showed abnormal uptake of the bilateral lacrimal glands and pulmonary hilum. A lacrimal gland biopsy showed noncaseating granulomatous infiltration with occasional multinucleated giant cells consistent with sarcoidosis. His symptoms improved by treatment with oral prednisolone and triamcinolone injection into the lacrimal glands.

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“…Las características mencionadas hacen difícil diferenciar estas dos enfermedades, a veces se trata de manera errónea la IgG4, bajo el supuesto diagnóstico de sarcoidosis (68) e incluso hay reportes en la literatura de pancreatitis por IgG4, con compromiso granulomatoso en ganglios mediastinales y pulmón, donde se plantea la coexistencia de ambas (69). Ante esta difícil situación, se ha propuesto la gammagrafía con galio-67 como herramienta útil en el diagnóstico diferencial, mediante la captación en páncreas, glándulas submandibular (especialmente si es asimétrica) en enfermedad por IgG4, mientras en la sarcoidosis este predomina en glándulas lacrimales, adenopatías supraclaviculares, mediastinales y el tejido muscular (70).…”

Section: Diagnóstico Diferencialunclassified

Sarcoidosis: muchas caras, una enfermedad. Revisión narrativa de la literatura

Chavarriaga-Restrepo

López-Amaya²,

Navas

et al. 2019

Iatreia

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RESUMENLa sarcoidosis es una enfermedad granulomatosa sistémica de etiología desconocida. Esta puede afectar a pacientes de todas las latitudes y edades, siendo más frecuente entre la tercera y cuarta década de la vida con un segundo pico alrededor de los 50 años en las poblaciones escandinava y japonesa. Es más frecuente en mujeres y grave en la población afrodescendiente. Los antígenos que inician esta respuesta granulomatosa son desconocidos, pero se presume que son aerotransportados por la alta frecuencia de compromiso pulmonar en esta enfermedad.Su presentación clínica abarca una amplia gama de manifestaciones, desde formas agudas y limitadas hasta el compromiso crónico con daño orgánico progresivo y muerte. Su diagnóstico se basa en la existencia de los granulomas no caseificantes en los tejidos, con la exclusión de otras enfermedades, entre ellas infección por micobacterias.

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Comparison between sarcoidosis and IgG4-related disease by whole-body 67Ga scintigraphy

Abstract: (67)Ga scintigraphy was useful in differentiating between the two diseases. Uptake in mediastinal LNs, in supraclavicular LNs, and in the muscle was specific to sarcoidosis, whereas uptake in the pancreas and in the submandibular gland indicated IgG4-related disease.

Cited by 11 publications

References 37 publications

Gallium SPECT/CT in evaluation of IgG4-related disease

Gallium SPECT/CT in evaluation of IgG4-related disease

A case of lacrimal sarcoidosis following interstitial pneumonia: imaging and management

Sarcoidosis: muchas caras, una enfermedad. Revisión narrativa de la literatura

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