title: IgG4-related disease manifesting the gastric wall thickening.
abstract: IgG4-related disease (IgG4-RD) is a recently designated disease entity and its full picture has not yet been elucidated. Here, we report an unusual case of a patient with gastric wall thickening secondary to IgG4-RD. A 68-year-old male visited our hospital with itchy skin lesions and an episode of organizing pneumonia. On the suspicion of malignancy-associated skin lesions, computed tomography (CT) was performed. The CT revealed prominent thickening of the gastric wall. Due to the possibility of malignancy, the patient underwent distal gastrectomy. Histopathological examination showed fibrosis of the submucosa and prominent thickening of the muscularis propria. Most of infiltrating cells were IgG4-positive plasma cells. Post-operative blood test revealed significantly high serum levels of total IgG and IgG4. Based on these histological features, the patient was given a definitive diagnosis of IgG4-RD. Further accumulation of cases like the present case that develop IgG4-RD with rare manifestations would lead to the elucidation of pathogenesis.
authors.affiliation: Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Ishii
authors.affiliation: Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Tokuhiro
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Saiseikai Yamaguchi Hospital, Yamaguchi, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Saiseikai Yamaguchi Hospital, Yamaguchi, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hironaka
authors.affiliation: Department of Internal Medicine, Saiseikai Yamaguchi Hospital, Yamaguchi, Japan.
authors.forename: Michitaka
authors.initials: M
authors.lastname: Kawano
authors.affiliation: Department of Dermatology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Yamaguchi
authors.affiliation: Department of Internal medicine, Ube Medical Center, Ube, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Oishi
authors.affiliation: Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kubo
authors.affiliation: Health Administration Center, Toyama University, Toyama, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Matsui
authors.affiliation: Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Notohara
authors.affiliation: Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005355:Fibrosis / Q000276:immunology / Q000473:pathology*; D041981:Gastrointestinal Tract / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D010950:Plasma Cells / Q000473:pathology; D011014:Pneumonia / Q000276:immunology / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D007074:Immunoglobulin G
keywords: IgG4; IgG4-related disease; gastric wall thickening