title: Development of IgG4-related disease 10 years after chemotherapy for diffuse large B cell lymphoma and longstanding bronchial asthma.
abstract: Reported is a rare case IgG4-related disease that developed 10 years after combination chemotherapy for non-Hodgkin lymphoma. A 59-year-old Japanese man with longstanding bronchial asthma was referred to our hospital for bilateral hilar lymph node enlargement. The initial diagnosis was diffuse large B cell lymphoma (DLBCL) by supraclavicular lymph node biopsy. Serum IgG was high (4550 mg/dL) at diagnosis. The patient achieved complete response following six cycles of combination chemotherapy. Ten years later, bilateral submaxillary gland swelling was observed. Serum IgG and IgG4 were 2909 and 1470 mg/dL, respectively. The patient was diagnosed with IgG4-related disease by submandibular lymph node biopsy. Due to the difficulty in distinguishing IgG4-related disease from DLBCL through imaging findings alone, pathological confirmation of such lesions by biopsy is mandatory before proceeding to treatment.
authors.affiliation: Department of Medicine and Clinical Sciences, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. mitsuit@gunma-u.ac.jp
authors.forename: Takeki
authors.initials: T
authors.lastname: Mitsui
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yokohama
authors.forename: Hiromi
authors.initials: H
authors.lastname: Koiso
authors.forename: Takuma
authors.initials: T
authors.lastname: Ishizaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Uchiumi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Saitoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.forename: Junko
authors.initials: J
authors.lastname: Hirato
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Karasawa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murakami
authors.forename: Masaru
authors.initials: M
authors.lastname: Kojima
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nojima
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsukamoto
mesh_terms: D001249:Asthma / Q000150:complications* / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D006942:Hypergammaglobulinemia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D007074:Immunoglobulin G / Q000032:analysis* / Q000096:biosynthesis; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged
chemical_list: D007074:Immunoglobulin G