title: IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy.
abstract: Immunoglobulin G4-related disease (IgG4-RD) is a recently described inflammatory disease involving multiple organs. Prostate involvement with IgG4-RD is very rare. In this report, we describe a case of IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy. This patient was present with urine retention symptoms. MRI and CT examination revealed the prostatic enlargement and the multiple lymphadenopathy. Serum IgG4 levels were elevated. Prostatic tissue samples resected both this time and less than 1 year earlier showed the same histological type of prostatitis with histopathologic and immunohistochemical findings characteristic of IgG4-RD. The right submandibular lymph nodes excised 2 years earlier were eventually proven to be follicular hyperplasia-type IgG4-related lymphadenopathy. This is the first case of IgG4-RD that began as localized IgG4-related lymphadenopathy and progressed into a systemic disease involving prostate and multiple lymph nodes. This patient showed a good response to steroid therapy. This leads us to advocate a novel pathogenesis of prostatitis, and a novel therapeutic approach against prostatitis. Pathologists and urologists should consider this disease entity in the patients with elevated serum IgG4 levels and the symptoms of prostatic hyperplasia to avoid ineffective medical or unnecessary surgical treatment.
authors.affiliation: Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Dujuan
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Yunzhen
authors.initials: Y
authors.lastname: Kan
authors.affiliation: Department of Radiology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Fangfang
authors.initials: F
authors.lastname: Fu
authors.affiliation: Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Shuhuan
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Ligang
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Urology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Lingfei
authors.initials: L
authors.lastname: Kong
mesh_terms: D000368:Aged; D018450:Disease Progression; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008206:Lymphatic Diseases / Q000276:immunology* / Q000473:pathology*; D008297:Male; D011472:Prostatitis / Q000276:immunology* / Q000473:pathology*
chemical_list: D007074:Immunoglobulin G
keywords: IgG4; IgG4-related disease; IgG4-related lymphadenopathy; IgG4-related prostatitis; Prostatitis