title: A case of mantle cell lymphoma presenting as IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz's disease.
abstract: BACKGROUND
  Mantle cell lymphoma (MCL) is a relatively uncommon type of non-Hodgkin lymphoma. It develops in the outer edge of a lymph node called the mantle zone. In contrast, IgG4-related dacryoadenitis and sialoadenitis (IgG4-DS) is characterized by elevated serum IgG4 and persistent bilateral enlargement of lacrimal glands (LGs) and salivary glands (SGs), with infiltration of IgG4-positive plasma cells. Recent studies indicated the importance of differentiation between IgG4-DS and malignant lymphoma.
  
  
  METHODS
  An 82-year-old man was suspected of IgG4-DS because of a high serum IgG level (2174 mg/dL) and bilateral swelling of LGs and SGs. Lip biopsy and fine needle biopsy of submandibular gland were performed, and subsequently, MCL was diagnosed through the histopathological findings.
  
  
  CONCLUSIONS
  MCL most commonly occurs in the Waldeyer ring, but rarely in the stomach, spleen, skin, LG, and SG. We report an unusual case of MCL involving LGs and SGs mimicking IgG4-DS, which suggests that IgG4 testing may be useful in the differentiation of IgG4-DS in the presence of bilateral swelling of LGs or SGs.
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hayashi@dent.kyushu-u.ac.jp.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. moriyama@dent.kyushu-u.ac.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Moriyama
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tmaehara@dent.kyushu-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maehara
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. ygoto@dent.kyushu-u.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Goto
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. skawano@dent.kyushu-u.ac.jp.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kawano
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. miho-o@dent.kyushu-u.ac.jp.
authors.forename: Miho
authors.initials: M
authors.lastname: Ohta
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. althair@dent.kyushu-u.ac.jp.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. s.furukawa@dent.kyushu-u.ac.jp.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Furukawa
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. junno@dent.kyushu-u.ac.jp.
authors.forename: Jun-Nosuke
authors.initials: JN
authors.lastname: Hayashida
authors.affiliation: Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. kiyo@dent.kyushu-u.ac.jp.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kiyoshima
authors.affiliation: Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. shimizu@rad.dent.kyushu-u.ac.jp.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. chikui@rad.dent.kyushu-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Chikui
authors.affiliation: Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. seiji@dent.kyushu-u.ac.jp.
authors.forename: Seiji
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000369:Aged, 80 and over; D003607:Dacryocystitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D020522:Lymphoma, Mantle-Cell / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008882:Mikulicz' Disease / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis; D012793:Sialadenitis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery
chemical_list: D007074:Immunoglobulin G