A case of IgG4-related pleuritis that required differentiation from malignant pleural mesothelioma
Hideto Oshitaa Tatsuki Takahashia Misato Senooa Kunihiko Funaishia Makoto Fujiwarab Ken Okusakia
aDepartment of Internal Medicine, Mihara Medical Association Hospital
bDepartment of Surgery, Mihara Medical Association Hospital
A 79-year-old man complained of dyspnea on exertion while receiving corticosteroid maintenance for IgG4-related autoimmune pancreatitis. Serum IgG4 was elevated, and FDG-PET showed right pleural thickening with FDG accumulation. He had a history of asbestos exposure and computed tomography (CT) showed multiple pleural plaques, suggesting malignant pleural mesothelioma. Pleural biopsy diagnosed IgG4-related pleuritis. Our case suggested an association between asbestos exposure and IgG4-related disease. IgG4-related pleuritis may present with pleural thickening accompanied by increased FDG accumulation, and caution should be taken to distinguish it from malignant pleural mesothelioma.
IgG4-related respiratory disease Malignant pleural mesothelioma Asbestos exposure Pleural biopsy
Received 26 Apr 2020 / Accepted 15 Jun 2020
AJRS, 9(5): 360-364, 2020