title: Thyroid papillary carcinoma with solid sclerosing change in IgG4-related sclerosing disease.
abstract: IgG4-related sclerosing disease (IgG4-RSD) is an inflammatory and fibrosing disorder characterized by lymphoplasmacytic inflammation with infiltration of various organs, including the pancreas, bile ducts, lung, kidney, and retroperitoneum. As for malignancy in IgG4-RSD, only limited literature is available. We report here a case of thyroid papillary carcinoma showing unique morphology in IgG4-RSD. Solid tumor nests were surrounded by dense IgG4-positive plasma cells and fibrosis at both the primary site and metastatic lymph nodes. In contrast the background thyroid showed focal lymphocytic thyroiditis. IgG4-related sclerosing sialadenitis and autoimmune pancreatitis were also diagnosed, and prednisolone treatment improved symptoms and serum IgG4 abnormality. To the best of our knowledge, this is the first documentation of a malignancy of the thyroid gland occurring in a background of IgG4-RSD. A brief review of the literature on the relationship between IgG4 and malignancy is included.
authors.affiliation: Department of Pathology, National Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki 856-8562, Japan. itohm@nmc.hosp.go.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Yuki
authors.initials: Y
authors.lastname: Naruke
authors.forename: Yumi
authors.initials: Y
authors.lastname: Mihara
authors.forename: Kenji
authors.initials: K
authors.lastname: So
authors.forename: Taiichiro
authors.initials: T
authors.lastname: Miyashita
authors.forename: Tomoki
authors.initials: T
authors.lastname: Origuchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakashima
authors.forename: Virginia
authors.initials: V
authors.lastname: Livolsi
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000276:immunology / Q000556:secondary*; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology*; D008297:Male; D010950:Plasma Cells / Q000473:pathology; D012598:Sclerosis; D013964:Thyroid Neoplasms / Q000276:immunology / Q000473:pathology*
chemical_list: D007074:Immunoglobulin G