title: Clinicopathology of Immunoglobulin G4-Related Chronic Sclerosing Sialadenitis: A Single-Center Study.
abstract: To investigate the clinicopathologic characteristics of patients with immunoglobulin G4-related chronic sclerosing sialadenitis (IgG4-RCSS), a recently recognized disease.
  
  
  
  Case series with chart review and pathology study.
  
  
  
  Tertiary care hospital.
  
  
  
  We evaluated chronic sialadenitis specimens obtained over 11 years using pathologic examination and IgG4 immunohistochemistry staining. The specimens were assigned a revised diagnosis of IgG4-RCSS or chronic sialadenitis not otherwise specified, and clinicopathologic data from each group were compared.
  
  
  
  Of the 84 patients, 21 were diagnosed with IgG4-RCSS and 63 with chronic sialadenitis not otherwise specified. IgG4-RCSS patients were older (68.2 ± 13.9 vs 54.2 ± 15.8 years, P = .001), predominantly male (85.7% vs 61.9%, P = .036), and more likely to present with painless swelling (75% vs 44.3%, P = .001) and bilateral involvement (52.4% vs 6.3%, P < .001). Ratio of IgG4-positive plasma cells to IgG-positive plasma cells in IgG4-RCSS tissues was 0.81 ± 0.14. The mean value of serum IgG4 in IgG4-RCSS patients was 918.8 mg/dL.
  
  
  
  IgG4-RCSS is more common in older male patients and frequently presents with bilateral involvement. Informing head and neck surgeons of the clinical features of IgG4-RCSS and promoting a combined approach of clinical evaluation, imaging, and biopsy can improve the accuracy of preoperative diagnoses.
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.|Division of Plastic and Reconstructive Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors: Dun-Hao
authors: DH
authors: Chang
authors: Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Pathology, MacKay Memorial Hospital, Taipei, Taiwan.
authors: Pao-Shu
authors: PS
authors: Wu
authors: Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Yu-Chen
authors: YC
authors: Wang
authors: Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Pathology, Cheng Ching Hospital, Taichung City, Taiwan.
authors: Chin-Hsuan
authors: CH
authors: Lin
authors: Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Wing-Yin
authors: WY
authors: Li
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors: Hsu
authors: H
authors: Ma
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan ckperng@vghtpe.gov.tw.|School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors: Chern-Kang
authors: CK
authors: Perng
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007155:Immunologic Factors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012793:Sialadenitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007155:Immunologic Factors
keywords: IgG4; chronic sclerosing sialadenitis; pathology; salivary gland; sialadenitis