Yoshimura Yukihiro, Takeda Shin-ichi, Ieki Yasuhiko, Takazakura Eisuke, Koizumi Hisashi, Takagawa Kiyoshi
Department of Internal Medicine, Kurobe City Hospital, Kurobe, Toyama.
Intern Med. 2006;45(15):897-901. doi: 10.2169/internalmedicine.45.1752. Epub 2006 Sep 1.
A 65-year-old man underwent transurethral resection of the prostate on a diagnosis of benign prostatic hypertrophy. Almost simultaneously, a diagnostic resection of minor salivary glands was performed. After the resections he suffered from obstructive jaundice. Laboratory examinations revealed an increase in eosinophils and an elevation of serum IgG4. Pancreaticoduodenectomy was performed because of the possibility of pancreatic cancer. The prostate, salivary glands and pancreas showed common histological characteristics, namely, infiltration of lymphocytes and plasma cells accompanying dense fibrosis. Most of the infiltrating plasma cells showed strong immunoreactivity to IgG4. This is the first case with IgG4-associated prostatitis complicating autoimmune pancreatitis.
一名65岁男性因诊断为良性前列腺增生而接受了经尿道前列腺切除术。几乎与此同时，对小唾液腺进行了诊断性切除。切除术后，他出现了梗阻性黄疸。实验室检查显示嗜酸性粒细胞增多和血清IgG4升高。由于存在胰腺癌的可能性，进行了胰十二指肠切除术。前列腺、唾液腺和胰腺显示出共同的组织学特征，即淋巴细胞和浆细胞浸润并伴有致密纤维化。大多数浸润的浆细胞对IgG4表现出强烈的免疫反应性。这是首例IgG4相关性前列腺炎并发自身免疫性胰腺炎的病例。
