title: A case of multiple immunoglobulin G4-related periarteritis: a tumorous lesion of the coronary artery and abdominal aortic aneurysm.
abstract: Immunoglobulin G4 (IgG4)-related disease can occur in various organs, most of which are glandular or ductal tissues. Here, we report a case of multiple IgG4-related vascular lesions. A 63-year-old patient was found to have an abdominal aortic aneurysm and a tumorous lesion around the right coronary artery. The surgically resected aneurysmal wall and a tumorous lesion of the right coronary artery showed similar histologic features including diffuse lymphoplasmacytic infiltration, occasional eosinophils, and obliterative phlebitis. Immunohistochemically, numerous IgG4-positive plasma cells were evident within the lesions. The serum concentrations of IgG4 in the preoperative period was 456 mg/dL (reference range, <135), which decreased to 242 mg/dL 2 weeks after surgery. We made a diagnosis of multiple IgG4-related periarteritis manifesting as an abdominal aortic aneurysm and a tumorous nodule of the coronary artery. This case report suggested that IgG4-related disease can occur in the vascular system and manifest as an aneurysm or a periarterial mass lesion.
authors.affiliation: Department of Cardiovascular Surgery, National Hospital Organization, Kanazawa Medical Center, Kanazawa 920-8650, Japan. matumoto@kinbyou.hosp.go.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Satomi
authors.initials: S
authors.lastname: Kasashima
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Kawashima
authors.forename: Hisao
authors.initials: H
authors.lastname: Sasaki
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Endo
authors.forename: Kengo
authors.initials: K
authors.lastname: Kawakami
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
mesh_terms: D001012:Aorta, Abdominal / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D001167:Arteritis / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D050197:Atherosclerosis / Q000276:immunology / Q000473:pathology; D003331:Coronary Vessels / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008875:Middle Aged
chemical_list: D007074:Immunoglobulin G