title: Immunoglobulin G4-related hypertrophic pachymeningitis involving cerebral parenchyma.
abstract: The authors report a case of IgG4-related hypertrophic pachymeningitis that involved cerebral parenchyma. The mass was removed surgically. Histopathological studies showed diffuse infiltration of lymphoplasmacytic cells without evidence of Langerhans histiocytes or meningothelial cells. Immunoglobulin G4 was strongly positive on immunohistochemical staining. The Gd-enhanced lesion deep inside brain parenchyma was completely resolved after 3 months of oral corticosteroid medication. A nodular type of hypertrophic pachymeningitis that mimics a meningioma is rare. Nevertheless, preoperative presumption is very important, and immunohistochemical studies for IgG4 may be helpful in the differential diagnosis.
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eui Hyun
authors.initials: EH
authors.lastname: Kim
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Cho
authors.forename: Jung Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Chang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D006984:Hypertrophy / Q000188:drug therapy / Q000276:immunology / Q000473:pathology / Q000601:surgery; D007074:Immunoglobulin G / Q000276:immunology* / Q000378:metabolism; D007150:Immunohistochemistry; D008297:Male; D008581:Meningitis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology* / Q000601:surgery; D012074:Remission Induction
chemical_list: D000305:Adrenal Cortex Hormones; D007074:Immunoglobulin G