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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of IgG4-related disease presenting with right pleural effusion and a pulmonary nodule with low density area

Hayato Yabea  Motoki Natsuizakaa  Hidetaka Yajimab  Toshinori Matsuic  Kiyoshi Kasaid 

aDepartment of Respiratory Medicine, Otaru General Hospital
bDepartment of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine
cDepartment of Otorhinolaryngology, Otaru General Hospital
dDepartment of Pathology, Otaru General Hospital

ABSTRACT

A 79-year-old man was referred to our hospital for detailed examination of right pleural effusion. He was asymptomatic, but physical examination revealed swelling of the right parotid gland. Pleural effusion was exudative with lymphoplasmacytic predominance. A chest computed tomography taken after drainage of pleural effusion showed swelling of mediastinal lymph nodes, a consolidation in the left lower lobe, and a nodule with a low density area in the right lower lobe. Biopsy specimens obtained from a right lower nodule and the right parotid gland showed IgG4-positive lymphoplasmacytic infiltration. Thus IgG4-related disease was diagnosed, and systemic corticosteroid therapy was commenced. Then thoracic lesions and the right parotid gland swelling were resolved, and his corticosteroid dose was tapered. To our knowledge, this appears to be the first case report of IgG4-related disease presenting with pleural effusion and a pulmonary nodule with a low density area.

KEYWORDS

IgG4-related disease  IgG4-related respiratory disease  Multicentric Castleman's disease  Pleural effusion 

Received 30 Jun 2015 / Accepted 13 Nov 2015

AJRS, 5(2): 90-95, 2016

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