IgG4-positive plasma cells in inflammatory pseudotumor (plasma cell granuloma) of the lung
IgG4-positive plasma cells in inflammatory pseudotumor (plasma cell granuloma) of the lung
复制标题
DOI：
10.1016/j.humpath.2005.05.011
复制
发表时间：
2005-07-01
期刊：
影响因子：
3.3
通讯作者：
Nakanuma, Y
中科院分区：
文献类型：
--
作者：
Zen, Y;Kitagawa, S;Nakanuma, Y
IgG4失调和炎性假瘤（IPT）之间的关联首次在硬化性胰腺炎中报道。最近，我们描述了肝脏和乳腺的IPT，其中许多IgG 4阳性浆细胞已浸润。在这项研究中，我们研究了9例IPT（组织学上对应于浆细胞肉芽肿）的肺与IgG 4阳性浆细胞浸润的重点的临床和组织学特征。病变的组织学特征为致密的淋巴浆细胞浸润与纤维化混合，在某些情况下，显著的嗜酸性粒细胞浸润，小支气管不规则狭窄夹在结节中，结节边界处的间质性肺炎模式。所有病例均易发现闭塞性静脉炎，5个病灶同时伴有闭塞性动脉炎。免疫组化显示许多IgG 4阳性浆细胞弥漫分布在结节内，IgG 4阳性的比例非常高，其他浆细胞。9例患者中，8例接受手术治疗，1例经支气管活检确诊，并给予皮质类固醇有效治疗。2例与慢性硬化性涎腺炎或淋巴结病，其中许多IgG 4阳性浆细胞也确定了免疫染色。肺IPT和硬化性胰腺炎之间的临床病理相似性表明，IgG 4相关的免疫病理过程可能参与了肺部病变的发病机制。(C)2005年爱思唯尔公司All rights reserved.
The association between IgG4 dysregulation and inflammatory pseudotumor (IPT) was first reported in sclerosing pancreatitis. Recently, we described IPTs of the liver and breast, into both of which many IgG4-positive plasma cells had infiltrated. In this study, we examined the clinical and histological features of 9 cases of IPT (histologically corresponding to plasma cell granuloma) of the lung with an emphasis on IgG4-positive plasma cell infiltration. The lesions were characterized histologically by dense lymphoplasmacytic infiltrates intermixed with fibrosis and, in some cases, prominent eosinophilic infiltration, irregular narrowing of bronchioles entrapped in nodules, and an interstitial pneumonia pattern at the boundaries of nodules. Obliterative phlebitis was easily found in all cases, and 5 lesions also had obliterative arteritis. Immunostaining revealed many IgG4-positive plasma cells diffusely distributed within nodules, and the ratios of IgG4-positive to other plasma cells were extraordinarily high. Of the 9 patients, 8 underwent surgical treatment and in I patient, lesion was diagnosed on transbronchial biopsy and effectively treated with corticosteroid. Two cases were associated with chronic sclerosing sialadenitis or lymphadenopathy, in which many IgG4-positive plasma cells were also identified by immunostaining. The clinicopathologic similarities between IPT of the lung and sclerosing pancreatitis suggest that IgG4-related immunopathologic processes might be involved in the pathogenesis of the pulmonary lesions. (C) 2005 Elsevier Inc. All rights reserved.