Autoimmune esophagitis: IgG4-related tumors of the esophagus.
We present a case of a 23-year-old gentleman who presented with dysphagia, weight loss, and recurrent esophageal strictures requiring multiple dilatations. An endoscopic ultrasound with esophagogastroduodenoscopy revealed a mass present in the distal esophagus. Fine needle aspiration suggested that the mass in the lower esophagus resembled a gastrointestinal stromal tumor. After surgical resection, final pathologic analysis revealed that the tumor was comprised of benign-appearing fibroinflammatory cells with an increase and predominance of IgG4-positive plasma cells. The microscopic appearance was consistent with a benign condition as a result of an IgG4-related process. He did not, however, have any other symptoms indicative of systemic autoimmune disease or connective tissue disorders. We present the pre-operative imaging, operative management, pathologic diagnosis, and literature review of this rare condition and the first known report of autoimmune esophagitis as part of the IgG4 spectrum of diseases.
Lopes
James
J
Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100109, Gainesville, FL 32610, USA.
Hochwald
Steven N
SN
Lancia
Nicholas
N
Dixon
Lisa R
LR
Ben-David
Kfir
K
D001327:Autoimmune Diseases / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D044963:Biopsy, Fine-Needle; D016629:Esophagectomy; D004941:Esophagitis / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D004947:Esophagus / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D010950:Plasma Cells / Q000473:pathology*; D055815:Young Adult
D007074:Immunoglobulin G