Cardiac Mass, Aortic Intramural Hematoma, and IgG4-related Disease: A Case Report.
As a designated entity within medicine, immunoglobulin G4 (IgG4)-related disease is relatively new. It is immune-mediated origin, characterized by a tendency for formation of tumefactive lesions, the infiltration of IgG4-positive plasma cells, and frequent but not invariable elevations of IgG4 levels in the serum. IgG4-related cardiac mass accompanying aortic intramural hematoma is an extremely rare clinical presentation. Herein we present the case of a patient who was admitted to our department complaining of severe chest pain. Computed tomographic angiography examination revealed a cardiac mass accompanying an aortic intramural hematoma. He underwent a surgical resection of the cardiac mass and a replacement of the ascending aorta with Hemashield Platinum graft and made an uneventful recovery. A diagnosis of an IgG4-related disease was made based on laboratory results and pathological examination. Corticosteroids were administered postoperatively. This case shows that the heart itself can also be a potential site for IgG4-related disease.
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Luocheng
L
Li
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. Electronic address: wangzhiwei@whu.edu.cn.
Zhiwei
Z
Wang
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Peng
P
Xu
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Yongle
Y
Ruan
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Wanli
W
Jiang
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Zhiyong
Z
Wu
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001011:Aorta / Q000276:immunology* / Q000473:pathology; D001018:Aortic Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery; D001027:Aortography / Q000379:methods; D001327:Autoimmune Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures; D000072226:Computed Tomography Angiography; D006331:Heart Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery; D006406:Hematoma / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology* / Q000601:surgery; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000276:immunology* / Q000473:pathology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D007074:Immunoglobulin G