title: Concomitant occurrence of Mikulicz's disease and immunoglobulin G4-related chronic rhinosinusitis: a clinicopathological study of 12 cases.
abstract: OBJECTIVE
  Concomitant occurrence of Mikulicz's disease (MD) and immunoglobulin (Ig)G4-related chronic rhinosinusitis (IgG4-related CRS) is extremely rare. We evaluated the clinicopathological features of MD patients with concomitant IgG4-related CRS (CRS-MD).
  
  
  RESULTS
  Twelve CRS-MD patients were evaluated clinically and biopsy samples were taken from the lacrimal/salivary glands (n = 12) and nasal mucosa (n = 7) for assessment of IgG4-positive cells, using immunohistochemical techniques. Similarly, nine MD patients and 10 patients with common CRS were evaluated as controls. CRS-MD patients had higher serum IgG and IgG4 concentrations than MD patients (P < 0.05 for both). Lymphoplasmacytic infiltration, lymphoid follicle formation and sclerosis was prominent in the lacrimal/salivary glands in both groups; however, the magnitude of IgG4-positive plasma cells infiltration in the CRS-MD group was significantly higher compared to the MD group (P = 0.004). Similarly, evaluation of nasal mucosa revealed greater lymphocyte, plasma cell and eosinophil infiltration and lymphoid follicle formation, together with significantly higher IgG4-positive plasma cell infiltration in the CRS-MD group compared to the common CRS group (P = 0.004).
  
  
  CONCLUSIONS
  Concomitant MD and IgG4-related CRS were characterized by a combination of IgG4-positive plasma cells infiltration in the lacrimal/salivary glands and the nasal mucosa and increased serum IgG4.
authors.affiliation: Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.|The Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yingshi
authors.initials: Y
authors.lastname: Piao
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
authors.forename: Chengshuo
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Radiology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
authors.forename: Wenling
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.|The Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
authors.forename: Meiling
authors.initials: M
authors.lastname: Mao
authors.affiliation: Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.|The Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
authors.forename: Changli
authors.initials: C
authors.lastname: Yue
authors.affiliation: Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.|The Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
authors.forename: Honggang
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.|Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China.
authors.forename: Luo
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007074:Immunoglobulin G; D008297:Male; D008875:Middle Aged; D008882:Mikulicz' Disease / Q000150:complications* / Q000276:immunology / Q000473:pathology; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D012852:Sinusitis / Q000150:complications* / Q000276:immunology / Q000473:pathology
chemical_list: D007074:Immunoglobulin G
keywords: IgG4-related disease; Mikulicz's disease; chronic rhinosinusitis