Immunoglobulin G4-Related Disease Mimicking an Anterior Mediastinal Tumor

Kang, Seung Ri; Kim, Hyeong Ryul; Nam, Soo Jeong; Hong, Sun In

doi:10.1016/j.athoracsur.2017.09.018

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…However, the tumor present in our case study was heterogeneous, whereas that reported by Iguchi and colleagues [4] was homogeneous. In the report of Kang and colleagues [5], the anterior mass shadow caused by IgG4-RD was a cystic mass with wall calcification, whereas our case demonstrated a solid shadow. These disparities indicate that isolated anterior mediastinal mass caused by IgG4-RD may be associated with several types of shadow, as well as with shadows in other affected organs.…”

Section: Commentcontrasting

confidence: 53%

“…In addition, some investigators have reported various types of lung disease accompanying systemic IgG4-RD [2]. However, to date there have been only a small number of reports describing an isolated anterior mediastinal mass caused by IgG4-RD [4,5]. We treated a patient with IgG4-RD exhibiting isolated anterior mediastinal mass that mimicked thymoma, and the mass was revealed to have a high level of [ 18 F]-fluoro-2-deoxy-D-glucose (FDG) accumulation.…”

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confidence: 99%

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Immunoglobulin G4-Related Disease Association With an Isolated Anterior Mediastinal Tumor

Yoshikawa

Igai

Ohsawa

et al. 2019

The Annals of Thoracic Surgery

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Section: Commentcontrasting

confidence: 53%

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confidence: 99%

Immunoglobulin G4-Related Disease Association With an Isolated Anterior Mediastinal Tumor

Yoshikawa

Igai

Ohsawa

et al. 2019

The Annals of Thoracic Surgery

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“…In a French study of 25 patients with IgG4‐related disease, 3 (12%) patients had pulmonary involvement, while none had mediastinal fibrosis . There have been only a few reports of occurrence in the anterior mediastinum …”

Section: Discussionmentioning

confidence: 99%

Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease

et al. 2018

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A 44‐year‐old man was referred to our hospital after an anterior mediastinal tumor was noted on computed tomography during follow‐up observation after left testicular seminoma resection. Chest computed tomography revealed an enhanced mass measuring 33 x 16 x 15 mm at the anterior mediastinum. Chest magnetic resonance imaging revealed high signal intensity on T2‐weighted imaging, and F18 fluorodeoxyglucose‐positron emission tomography showed a maximum standardized uptake of 12.45. Laboratory tests revealed no elevated tumor markers, except for mildly elevated interleukin‐2. Based on these results, complete resection was performed under suspicion of a malignant tumor, mediastinal metastasis of seminoma, or malignant lymphoma. An extended thymectomy with partial merger pericardial resection was performed using a subxiphoid approach. Small nodules and multiple thymic cysts were observed the thymus in addition to the main mass. Microscopic examination of the tumor revealed fibrosis, lymphocyte infiltration with lymphoid follicular hyperplasia, and hyperplasia of the thymus. Numerous immunoglobulin G4 (IgG4)‐positive plasma cells were found on immunohistochemical staining. The ratio of IgG4 to total IgG was approximately 60%. We ultimately diagnosed the patient with a thymic inflammatory pseudotumor with multilocular cyst caused by IgG4‐related disease.

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Isolated middle mediastinal mass associated with immunoglobulin G4-related disease

et al. 2021

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Background Immunoglobulin G4-related disease (IgG4-RD) is a multi-organ disorder predominantly occurring in middle-aged to elderly male patients characterized by multi-organ fibrosis, specific pathological findings of storiform fibrosis with IgG4-positive plasma cell infiltration, and elevated serum IgG4 level. We herein report a rare presentation of IgG4-RD forming an isolated mass in the middle mediastinum mimicking a mediastinal tumor and discuss the clinical significance of mediastinal IgG4-RD. Case presentation An 82-year-old male patient without any symptom was referred due to left middle mediastinal mass (3.8 × 2.4 cm). Because of suspected lymphoma, Castleman’s disease, and lymphangitis due to tuberculosis, we performed a thoracoscopic resection for diagnosis and treatment. The mass was yellowish white with well-encapsulated, and storiform fibrosis with plasma cell infiltration, and obliterative phlebitis were observed microscopically. Additional immunohistochemical stain revealed IgG4-RD. Other radiological findings and serological results did not show evidence of other organs being affected from IgG4-RD nor autoimmune diseases. He is now followed at outpatient clinic without additional treatment for over a year, and an enhanced computed tomography does not show any recurrence. Conclusion It was a rare presentation of IgG4-RD forming isolated middle mediastinal mass, which suggests that we might suspect IgG4-RD for undetermined mediastinal mass in case of middle to elderly male patient.

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Immunoglobulin G4-Related Disease Mimicking an Anterior Mediastinal Tumor

Cited by 4 publications

References 9 publications

Immunoglobulin G4-Related Disease Association With an Isolated Anterior Mediastinal Tumor

Immunoglobulin G4-Related Disease Association With an Isolated Anterior Mediastinal Tumor

Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease

Isolated middle mediastinal mass associated with immunoglobulin G4-related disease

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