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3 "Autoimmune diseases"
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Case Studies
Gastric IgG4-related disease presenting as a mass lesion and masquerading as a gastrointestinal stromal tumor
Banumathi Ramakrishna, Rohan Yewale, Kavita Vijayakumar, Patta Radhakrishna, Balakrishnan Siddartha Ramakrishna
J Pathol Transl Med. 2020;54(3):258-262.   Published online March 4, 2020
DOI: https://doi.org/10.4132/jptm.2020.02.10
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  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
IgG4-related disease of the stomach is a rare disorder, and only a few cases have been reported. We present two cases that were identified over a 2-month period in our center. Two male patients aged 52 and 48 years presented with mass lesion in the stomach, which were clinically thought to be gastrointestinal stromal tumor, and they underwent excision of the lesion. Microscopic examination revealed marked fibrosis, which was storiform in one case, associated with diffuse lymphoplasmacytic infiltration and an increase in IgG4-positive plasma cells on immunohistochemistry. Serum IgG4 level was markedly elevated. Although rare, IgG4-related disease should be considered in the differential diagnosis of gastric submucosal mass lesions.

Citations

Citations to this article as recorded by  
  • CGB5, INHBA and TRAJ19 Hold Prognostic Potential as Immune Genes for Patients with Gastric Cancer
    Bei Ji, Lili Qiao, Wei Zhai
    Digestive Diseases and Sciences.2023; 68(3): 791.     CrossRef
  • IgG4-related diseases of the digestive tract
    J.-Matthias Löhr, Miroslav Vujasinovic, Jonas Rosendahl, John H. Stone, Ulrich Beuers
    Nature Reviews Gastroenterology & Hepatology.2022; 19(3): 185.     CrossRef
  • Clinicopathological characteristics of gastric IgG4‐related disease: Systematic scoping review
    Haruki Sawada, Torrey Czech, Krixie Silangcruz, Landon Kozai, Adham Obeidat, Eric Andrew Wien, Midori Filiz Nishimura, Asami Nishikori, Yasuharu Sato, Yoshito Nishimura
    Journal of Gastroenterology and Hepatology.2022; 37(10): 1865.     CrossRef
  • Utility of gastric biopsy in diagnosing IgG4‐related gastrointestinal disease
    Kaori Uchino, Kenji Notohara, Takeshi Uehara, Yasuhiro Kuraishi, Junya Itakura, Akihiro Matsukawa
    Pathology International.2021; 71(2): 124.     CrossRef
IgG4-Related Disease Presented as a Mural Mass in the Stomach
Chang Gok Woo, Jeong Hwan Yook, Ah Young Kim, Jihun Kim
J Pathol Transl Med. 2016;50(1):67-70.   Published online September 30, 2015
DOI: https://doi.org/10.4132/jptm.2015.07.28
  • 8,120 View
  • 84 Download
  • 21 Web of Science
  • 21 Crossref
AbstractAbstract PDF
Isolated gastric IgG4-related disease (IgG4-RD) is a very rare tumefactive inflammatory condition, with only a few cases reported to date. A 48-year-old woman was incidentally found to have a subepithelial tumor in the stomach. Given a presumptive diagnosis of gastrointestinal stromal tumor or neuroendocrine tumor, she underwent wedge resection. The lesion was vaguely nodular and mainly involved the submucosa and proper muscle layer. Microscopically, all classical features of type I autoimmune pancreatitis including lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis, and numerous IgG4-positive plasma cells were seen. She had no evidence of IgG4-RD in other organs. Although very rare, IgG4-RD should be considered one of the differential diagnoses in the setting of gastric wall thickening or subepithelial mass-like lesion. Deep biopsy with awareness of this entity might avoid unnecessary surgical intervention.

Citations

Citations to this article as recorded by  
  • Value of High‐Frequency Ultrasonography in the Qualitative and Semi‐Quantitative Assessment of Immunoglobulin G4‐Related Submandibular Sialadenitis
    Lei Chen, Lin Nong, Jumei Liu, Luzeng Chen, Yuhong Shao, Xiuming Sun
    Journal of Ultrasound in Medicine.2023; 42(10): 2235.     CrossRef
  • IgG4-related pseudotumours: a series of 12 cases and a review of the literature
    Andrea Maccagno, Bianca Grosser, László Füzesi, Björn Konukiewitz, Dmytro Vlasenko, Dorothea Weckermann, Stephan Raab, Johannes Zenk, Abbas Agaimy, Bruno Märkl
    Pathology.2022; 54(5): 563.     CrossRef
  • IgG4-Related Disease With Gastrointestinal Involvement: Case Reports and Literature Review
    Xinhe Zhang, Xing Jin, Lin Guan, Xuyong Lin, Xuedan Li, Yiling Li
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • Clinicopathological characteristics of gastric IgG4‐related disease: Systematic scoping review
    Haruki Sawada, Torrey Czech, Krixie Silangcruz, Landon Kozai, Adham Obeidat, Eric Andrew Wien, Midori Filiz Nishimura, Asami Nishikori, Yasuharu Sato, Yoshito Nishimura
    Journal of Gastroenterology and Hepatology.2022; 37(10): 1865.     CrossRef
  • Utility of gastric biopsy in diagnosing IgG4‐related gastrointestinal disease
    Kaori Uchino, Kenji Notohara, Takeshi Uehara, Yasuhiro Kuraishi, Junya Itakura, Akihiro Matsukawa
    Pathology International.2021; 71(2): 124.     CrossRef
  • A reappraisal of sclerosing nodular and/or polypoid lesions of the gastrointestinal tract rich in IgG4‐positive plasma cells
    Runjan Chetty
    Histopathology.2020; 76(6): 832.     CrossRef
  • Gastric IgG4-related disease presenting as a mass lesion and masquerading as a gastrointestinal stromal tumor
    Banumathi Ramakrishna, Rohan Yewale, Kavita Vijayakumar, Patta Radhakrishna, Balakrishnan Siddartha Ramakrishna
    Journal of Pathology and Translational Medicine.2020; 54(3): 258.     CrossRef
  • IgG4-related Sclerosing Disease Forming a Gastric Submucosal Tumor Diagnosed after Laparoscopic Endoscopic Cooperative Surgery—Report of a Case—
    Tatsuki ISHIKAWA, Katsunori NAKANO, Masafumi OSAKA, Yayoi KADOTANI, Kaori OKUGAWA, Kiyokazu AKIOKA, Kenta SHIGEMORI, Yohei HOSOKAWA
    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2020; 81(2): 254.     CrossRef
  • Calcifying fibrous tumor of the gastrointestinal tract: A clinicopathologic review and update
    Donald Turbiville, Xu-Chen Zhang
    World Journal of Gastroenterology.2020; 26(37): 5597.     CrossRef
  • A Suspected Case of IgG4-Related Appendiceal Pseudotumor
    Yudai Hojo, Yoshiharu Shirakata, Ai Izumi, Jun Matsui, Tokuyuki Yamashita, Hikaru Aoki, Makoto Kurimoto, Masaaki Hirata, Naoki Goda, Hiroaki Ito, Jun Tamura
    The Japanese Journal of Gastroenterological Surgery.2020; 53(12): 976.     CrossRef
  • Immunoglobulin G4-related gastric pseudotumor – An impostor: Case report
    Manuel Santiago Mosquera, Andrea Suarez Gómez, Hugo Herrera, Karen Moreno-Medina, Alejandro González-Orozco, Carlos J-Perez Rivera
    International Journal of Surgery Case Reports.2020; 75: 333.     CrossRef
  • Imaging and pathological features of gastric lesion of immunoglobulin G4-related disease: A case report and review of the recent literature
    Dai Inoue, Norihide Yoneda, Kotaro Yoshida, Hiromi Nuka, Jun Kinoshita, Sachio Fushida, Fumihito Toshima, Tetsuya Minami, Masayuki Takahira, Shoko Hamaoka, Hiroko Ikeda, Toshifumi Gabata, Mitsuhiro Kawano
    Modern Rheumatology.2019; 29(2): 377.     CrossRef
  • Immunoglobulin G4-Related Gastric Ulcer Mimicking Advanced Stomach Cancer in a Patient with Type I Autoimmune Pancreatitis
    Joung Ha Park, Jin Hee Noh, Jang ho Lee, Goeun Lee, Seung-Mo Hong, Kwang Bum Cho, Myung-Hwan Kim
    The Korean Journal of Medicine.2019; 94(3): 287.     CrossRef
  • Review of IgG4-related disease
    Raquel Sánchez-Oro, Elsa María Alonso-Muñoz, Lidia Martí Romero
    Gastroenterología y Hepatología (English Edition).2019; 42(10): 638.     CrossRef
  • Revisión de la enfermedad relacionada con la IgG4
    Raquel Sánchez-Oro, Elsa María Alonso-Muñoz, Lidia Martí Romero
    Gastroenterología y Hepatología.2019; 42(10): 638.     CrossRef
  • Gastrointestinal manifestation of immunoglobulin G4-related disease: clarification through a multicenter survey
    Kenji Notohara, Terumi Kamisawa, Kazushige Uchida, Yoh Zen, Mitsuhiro Kawano, Satomi Kasashima, Yasuharu Sato, Masahiro Shiokawa, Takeshi Uehara, Hajime Yoshifuji, Hiroko Hayashi, Koichi Inoue, Keisuke Iwasaki, Hiroo Kawano, Hiroyuki Matsubayashi, Yukitos
    Journal of Gastroenterology.2018; 53(7): 845.     CrossRef
  • IgG4-Related Disease Mimicking Crohn’s Disease: A Case Report and Review of Literature
    Fabiana Ciccone, Antonio Ciccone, Mirko Di Ruscio, Filippo Vernia, Gianluca Cipolloni, Gino Coletti, Giuseppe Calvisi, Giuseppe Frieri, Giovanni Latella
    Digestive Diseases and Sciences.2018; 63(4): 1072.     CrossRef
  • IgG4-related Disease in the Stomach which Was Confused with Gastrointestinal Stromal Tumor (GIST): Two Case Reports and Review of the Literature
    Ho Seok Seo, Yoon Ju Jung, Cho Hyun Park, Kyo Young Song, Eun Sun Jung
    Journal of Gastric Cancer.2018; 18(1): 99.     CrossRef
  • Multivisceral IgG4-related disease presenting as recurrent massive gastrointestinal bleeding: a case report and literature review
    Xuexue Deng, Ronghua Fang, Jianshu Zhang, Rongqiong Li
    BMC Gastroenterology.2018;[Epub]     CrossRef
  • IgG4-Related Sclerosing Disease Presenting as a Gastric Submucosal Tumor
    Takashi Masuda, Toshifumi Matsumoto, Yushi Kaishakuji, Hirotada Tajiri, Akinori Egashira, Hirofumi Kawanaka
    The Japanese Journal of Gastroenterological Surgery.2018; 51(10): 599.     CrossRef
  • A rare case of IgG4-related disease: a gastric mass, associated with regional lymphadenopathy
    Dimitar Bulanov, Elena Arabadzhieva, Sasho Bonev, Atanas Yonkov, Diana Kyoseva, Tihomir Dikov, Violeta Dimitrova
    BMC Surgery.2016;[Epub]     CrossRef
Original Article
Differential Expression of Promyelocytic Leukemia Protein in Autoimmune Liver Diseases.
Hyun Jung Kim, Jung Sun Kim, Yong Sang Lee, Young Hwa Chung, Han Joo Lee, Dong Jin Suh, Chong Jai Kim, Eunsil Yu
Korean J Pathol. 2004;38(6):357-363.
  • 1,551 View
  • 16 Download
AbstractAbstract PDF
BACKGROUND
Promyelocytic leukemia protein (PML) is a primary biliary cirrhosis (PBC)-specific autoantigen. Anti-PML antibody is analyzed using cultured cells with patient sera, however, PML expression has rarely been examined in liver tissues.
METHODS
In the present study, PML expression was examined immunohistochemically in paraffin embedded liver needle biopsy specimens obtained from 20 cases of PBC, 10 cases of autoimmune cholangitis, 36 cases of autoimmune hepatitis and from 5 cases of noninflammatory livers.
RESULTS
Variable PML immunopositivity was detected in the bile duct epithelial cells of 18 (90.0%) of 20 PBC cases and in all 10 cases (100.0%) of autoimmune cholangitis, whereas it was only present in 6 (16.7%) of 36 cases of autoimmune hepatitis (p<0.001). In contrast, hepatocyte PML immunopositivity was higher in autoimmune hepatitis (33/36 cases, 90.8%), than in PBC (10/20 cases, 50.0%) or autoimmune cholangitis (3/10 cases, 30.0%) (p<0.05).
CONCLUSION
Our data indicate that the differential expression of PML is closely related to autoimmune liver diseases type, and suggest that the overexpression of PML protein in bile duct cells is associated with the development of autoantibodies in patients with PBC or autoimmune cholangitis. Furthermore, PML immunoreactivity may be useful for the diagnosis of autoimmune cholangitis and overlap syndrome.

J Pathol Transl Med : Journal of Pathology and Translational Medicine