High serum immunoglobulin G4-related retrosternal fibrosclerosis.
A 65-year-old man with a history of exposure to asbestos complained of left leg edema. Computed tomography showed a flat, symmetrical, and longitudinal retrosternal thickening in addition to a presacral tumor. Retroperitoneal fibrosis was suspected. Serum immunoglobulin G4 (IgG4) levels were elevated (213 mg/dL). Thoracoscopic biopsy was performed. Histopathologic findings showed fibrotic tissue accompanied by proliferation of IgG4-positive plasma cells (proportion of IgG4/IgG-positive plasma cells ≥70%) indicative of multifocal fibrosclerosis.
Department of General Thoracic Surgery, Yokohama Municipal Citizen's Hospital, Kanagawa-ken, Japan. k_kamiya0329@yahoo.co.jp
Kazunori
K
Kamiya
Akira
A
Yoshizu
Tomonori
T
Nakazato
Hiroyuki
H
Hayashi
Naoya
N
Hida
Hiroaki
H
Okamoto
D000368:Aged; D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D012185:Retroperitoneal Fibrosis / Q000097:blood / Q000151:congenital* / Q000000981:diagnostic imaging / Q000473:pathology; D012598:Sclerosis; D013249:Sternum / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods
D007074:Immunoglobulin G