title: IgG4-related disease-like fibrosis as an indicator of IgG4-related lymphadenopathy.
abstract: The significance of IgG4-related diseases including IgG4-related lymphadenopathy has recently been recognized worldwide. Inflammatory pseudotumors in lymph nodes, as well as in other organs, are also recognized as IgG4-related diseases. Only a few case reports have described IgG4-related lymphadenopathy with fibrosis (IgG4-fibrosing lymphadenopathy), and IgG4-fibrosing lymphadenopathy has not been compared clinicopathologically with non-IgG4-related lymphadenopathy with fibrosis. We have evaluated the pathologic features in 13 patients with IgG4-fibrosing lymphadenopathy, including IgG4 and IgG expression in lymph nodes, and compared these features with those of patients with non-IgG4-related lymphadenopathy with fibrosis with reactive inguinal lymphadenopathy and focal fibrosis and lymph nodes at least 10 mm in diameter. IgG4-fibrosing lymphadenopathy was characterized by lymphoplasmacytic and eosinophilic infiltration, many IgG4-positive plasma cells in fibrotic areas, and high serum IgG4 concentrations. The IgG4-positive/IgG-positive plasma cell ratio was significantly higher in the IgG4-fibrosing lymphadenopathy than in the non-IgG4-fibrosing lymphadenopathy group. The presence of even minor fibrosis with characteristics of IgG4-related disease such as IgG4-fibrosing lymphadenopathy may facilitate the diagnosis of IgG4-related lymphadenopathy.
authors.affiliation: Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto 390-8621, Japan. Electronic address: tuehara@shinshu-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uehara
authors.forename: Junya
authors.initials: J
authors.lastname: Masumoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hamano
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Oki
authors.forename: Nao
authors.initials: N
authors.lastname: Oikawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Honda
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005355:Fibrosis / Q000276:immunology / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007150:Immunohistochemistry; D007249:Inflammation / Q000276:immunology / Q000473:pathology; D008206:Lymphatic Diseases / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged
chemical_list: D007074:Immunoglobulin G
keywords: IP; IgG4-fibrosing lymphadenopathy; IgG4-lymphadenopathy; IgG4-positive plasma cell/IgG-positive plasma cell ratio; IgG4-related diseases; IgG4-related lymphadenopathy; IgG4-related lymphadenopathy with fibrosis; IgG4/IgG ratio; Non–IgG4-fibrosing lymphadenopathy; inflammatory pseudotumor; non–IgG4-related lymphadenopathy with fibrosis