Ahn Jee Hwan, Hong Sun In, Cho Dong Hui, Chae Eun Jin, Song Joon Seon, Song Jin Woo
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Tuberc Respir Dis (Seoul). 2014 Aug;77(2):85-9. doi: 10.4046/trd.2014.77.2.85. Epub 2014 Aug 29.
Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.
免疫球蛋白G4（IgG4）相关疾病的胸内受累情况近来已有报道。然而，该疾病以间质性肺疾病形式出现的亚型较为罕见。在此，我们报告一例35岁男性IgG4相关肺疾病患者，其表现与间质性肺疾病相似。胸部计算机断层扫描显示双上叶弥漫性磨玻璃影以及快速进展的胸膜和胸膜下纤维化。组织学检查结果显示弥漫性间质淋巴细胞浆细胞浸润，IgG4阳性浆细胞数量增加。血清IgG和IgG4水平也升高。该患者被诊断为IgG4相关肺疾病，接受抗炎药物治疗后病情改善。IgG4相关疾病的肺部受累可表现为间质性肺疾病，因此在评估间质性肺疾病时应加以鉴别。
