title: A clinicopathologic study of immunoglobulin G4-related disease of the femoral and popliteal arteries in the spectrum of immunoglobulin G4-related periarteritis.
abstract: BACKGROUND
  Immunoglobulin (Ig) G4-related disease has recently been recognized to occur in the cardiovascular system in the aorta and main branching arteries, often manifesting as aneurysms and arteritis/periarteritis. Peripheral arteries (the femoral and popliteal arteries) are frequent sites of arteriosclerosis obliterans (ASO) and occasionally show aneurysms or arteritis. This study re-examined peripheral arterial lesions from the standpoint of IgG4-related disease.
  
  
  METHODS
  The study comprised 104 patients who underwent surgical treatment of peripheral arterial lesions, including 30 patients with peripheral arterial aneurysms (PAAs) and 74 with ASO. IgG4-related disease was identified on the basis of diffuse infiltration of numerous IgG4-positive plasmacytes as revealed by immunohistochemical examination. Clinicopathologic features were compared between IgG4-related and IgG4-unrelated lesions.
  
  
  RESULTS
  IgG4-related disease was found in four of the 30 patients with PAAs (13.3%; two in the deep femoral artery, two in the popliteal artery) but not in any patients with ASO. IgG4-related PAA displayed clinicopathologic features resembling those of other IgG4-related diseases and a characteristic saccular appearance (P = .002).
  
  
  CONCLUSIONS
  IgG4-related disease was detected in PAA patients but not in ASO patients. IgG4-related disease thus represents one potential etiology of aneurysm in the peripheral arteries.
authors.affiliation: Department of Pathology, National Hospital Organization, Kanazawa Medical Center, Kanazawa, Japan. sato-kasa@kinbyou.hosp.go.jp
authors.forename: Satomi
authors.initials: S
authors.lastname: Kasashima
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Kawashima
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Endo
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Fuminori
authors.initials: F
authors.lastname: Kasashima
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000097:blood / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D001162:Arteriosclerosis Obliterans / Q000097:blood / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D001167:Arteritis / Q000097:blood / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D015415:Biomarkers / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D005263:Femoral Artery / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D005355:Fibrosis; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology; D011150:Popliteal Artery / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G