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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2019.02.21    [Epub ahead of print]
A Rare Case of Adenosquamous Carcinoma Arising in a Background of IgG4-Related Lung Disease: A case report
Sangjoon Choi1, Sujin Park1, Man Pyo Chung2, Tae Sung Kim3, Jong Ho Cho4, Joungho Han1
1Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
4Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Corresponding Author: Joungho Han ,Tel: +82-2-3410-2800, Fax: +82-2-3410-0025, Email: hanjho@skku.edu
Received: December 3, 2018;  Revised: January 26, 2019  Accepted: February 20, 2019.  Published online: March 11, 2019.
ABSTRACT
Immunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease and is known as IgG4-related lung disease (IgG4-RLD) when it involves the respiratory system. Primary lung cancer arising from a background of IgG4-RLD is very rare. Herein, we report a case of adenosquamous carcinoma arising from the background of IgG4-RLD and presenting as an interstitial lung disease pattern. A 66-year-old man underwent lobectomy under the impression of primary lung cancer. Grossly, the mass was ill-defined and gray-tan colored, and the background lung was fibrotic. Microscopically, tumor cells showed both squamous and glandular differentiation. Dense lymphoplasmacytic infiltration with fibrosis and obliterative phlebitis were seen in the background lung. IgG4 immunohistochemical stain showed diffuse positivity in infiltrating plasma cells. Primary lung adenosquamous carcinoma has not been reported in a background of IgG4-RLD. Due to the rarity of IgG4-RLD, physicians must follow patients with IgG4-RLD over long periods of time to accurately predict the risk of lung cancer.
Key Words: Lung; Neoplasm; IgG4-related disease; Autoimmune