Sakashita Kentaro, Takamori Mikio, Murata Kengo, Wada Akihiko, Fujita Akira, Enatsu Kazuaki
Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center.
Nihon Kokyuki Gakkai Zasshi. 2011 Mar;49(3):172-7.
A 72-year-old man visited our hospital due to persistent cough, fever and weight loss. A chest X-ray film revealed a round tumor in the left lower lung field. A specimen obtained by transbronchial lung biopsy demonstrated histiocytic and lymphocytic infiltration in the alveolar space, with spindle myofibroblasts and plasmacytes in the interstitium, Those findings were consistent with inflammatory pseudotumor. Four weeks later, a chest X-ray film showed only scars of the primary lesion, and his symptoms resolved dramatically. He has had no recurrence of symptoms and pulmonary tumor since then. Although spontaneous remission is uncommon in inflammatory pseudotumor of the lung, there are several case reports about spontaneous remission of hepatic inflammatory pseudotumor and autoimmune pancreatitis, parts of IgG4-related sclerosing disease. Recently, inflammatory pseudotumor is thought to be IgG4-related sclerosing disease. We speculate that IgG4 may be associated with spontaneous remission of inflammatory pseudotumor of the lung, and we discuss this issue in relation to the pertinent literature.
一名72岁男性因持续咳嗽、发热和体重减轻前来我院就诊。胸部X线片显示左下肺野有一个圆形肿瘤。经支气管肺活检获取的标本显示肺泡腔内有组织细胞和淋巴细胞浸润，间质中有梭形肌成纤维细胞和浆细胞，这些表现符合炎性假瘤。四周后，胸部X线片仅显示原发性病变的瘢痕，其症状显著缓解。自那时起，他未再出现症状复发及肺部肿瘤。虽然肺部炎性假瘤自发缓解并不常见，但有几例关于肝脏炎性假瘤和自身免疫性胰腺炎自发缓解的病例报告，它们均属于IgG4相关硬化性疾病的一部分。近来，炎性假瘤被认为是IgG4相关硬化性疾病。我们推测IgG4可能与肺部炎性假瘤的自发缓解有关，并结合相关文献对这一问题进行讨论。
