title: Autoimmune esophagitis: IgG4-related tumors of the esophagus.
abstract: 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.
authors.affiliation: Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100109, Gainesville, FL 32610, USA.
authors.forename: James
authors.initials: J
authors.lastname: Lopes
authors.forename: Steven N
authors.initials: SN
authors.lastname: Hochwald
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lancia
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Dixon
authors.forename: Kfir
authors.initials: K
authors.lastname: Ben-David
mesh_terms: 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
chemical_list: D007074:Immunoglobulin G