Article

An immunoglobulin G4-related disease mimicking postoperative lung cancer recurrence.

Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Modern Rheumatology (impact factor: 1.58). 01/2012; 22(5):787-90. DOI:10.1007/s10165-011-0580-y pp.787-90
Source: PubMed

ABSTRACT A postoperative lung cancer patient presented with lymphadenopathy, pleural thickening, and 18F-fluorodeoxyglucose (FDG) uptake on a positron emission tomography-computed tomography (PET-CT) scan. Lung cancer recurrence was initially suspected, but bilateral submandibular masses with 18F-FDG uptake indicated the possibility of a systemic disease, such as Mikulicz's disease. High serum immunoglobulin G4 (IgG4) and IgG4-positive plasma cell infiltration in the submandibular glands led to the diagnosis of IgG4-related disease. After systemic steroid therapy, 18F-FDG uptake decreased in both the submandibular glands and the suspected recurrent lesions.

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Keywords

18F-FDG uptake
 
bilateral submandibular masses
 
IgG4
 
IgG4-positive plasma cell infiltration
 
IgG4-related disease
 
Lung cancer recurrence
 
Mikulicz's disease
 
PET-CT
 
positron emission tomography-computed tomography
 
postoperative lung cancer patient
 
serum immunoglobulin G4
 
submandibular glands
 
suspected recurrent lesions