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Abstract

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Article in Japanese

Case Report

A case of pleuritis in which it was necessary to distinguish immunoglobulin G4-related disease from Rosai-Dorfman disease

Yuji Katagiria  Tomoyasu Yahagib  Mitsumasa Osakabec  Naoki Yanagawad  Toshihiko Hinoa  Hiroki Suzukia 

aDepartment of Respiratory Medicine, Yamagata Prefectural Central Hospital
bDepartment of Cardiology, Yamagata Prefectural Central Hospital
cDepartment of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine
dDepartment of Pathology and Laboratory Medicine, Yamagata Prefectural Central Hospital

ABSTRACT

A 76-year-old man presented with the chief complaints of generalized malaise and precordial discomfort. Clinical examination revealed evidence of pericardial and pleural effusions. Under microscopic examination, the pleural fluid was shown to contain abundant lymphocytes and histiocytes, including many clusters of differentiated CD4-positive T-lymphocytes. Cells with emperipolesis that appeared to be positive for S-100 protein expression were also detected. A pleural biopsy performed two months later revealed proliferating eosinophils. There was also marked lymphocyte and plasma cell infiltration and fibrosis, and based on elevation of the serum IgG4 levels, the diagnosis of IgG4-related pleuritis was made. This condition needed to be differentiated from Rosai-Dorfman disease (RDD) in the patient. Accordingly, this case study provides valuable insights into the pathology of IgG4-related diseases and Rosai-Dorfman disease.

KEYWORDS

IgG4-related pleuritis  Rosai-Dorfman disease (RDD)  Emperipolesis  Histiocyte  T-lymphocyte 

Received 10 Nov 2018 / Accepted 1 Mar 2019

AJRS, 8(4): 264-268, 2019

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