患有威尔斯综合征患者的睾丸旁IgG4相关性疾病：一例报告

IgG4-related disease of the paratestis in a patient with Wells syndrome: a case report.

作者信息

Karashima Takashi, Taniguchi Yoshinori, Shimamoto Tsutomu, Nao Tomoya, Nishikawa Hiroshi, Fukata Satoshi, Kamada Masayuki, Inoue Keiji, Oko Kentaro, Nakajima Hideki, Sano Shigetoshi, Matsumoto Manabu, Kuroda Naoto, Kamei Yoshihiro, Shuin Taro

机构信息

Department of Urology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, 783-8505, Japan.

Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Nankoku, 783-8505, Japan.

出版信息

Diagn Pathol. 2014 Dec 9;9:225. doi: 10.1186/s13000-014-0225-5.

DOI:10.1186/s13000-014-0225-5

PMID:25487870

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4265405/

Abstract

BACKGROUND

We report a case of a 33-year-old man who presented with immunoglobulin (Ig)G4-related disease (IgG4-RD) forming a pseudotumor in the left paratesticular region during oral administration of corticosteroid for Wells syndrome, which involves cellulitis with eosinophilia.

CASE PRESENTATION

The patient was introduced to our institution from a private hospital with a 3-month history of asymptomatic left scrotal mass. A 5-cm diameter nodule was palpable in the left scrotum. Tumor lesion in the left paratestis involving the epididymis and spermatic cord was observed on computed tomography and magnetic resonance imaging. Blood testing showed no abnormalities other than a minimal increase in C-reactive protein levels. Urine examination likewise revealed no significant findings. Left radical orchidectomy was performed under a diagnosis of left paratesticular neoplasm suspected as malignant tumor. The tumor was pathologically identified as IgG4-RD of the left paratestis involving the epididymis and spermatic cord.

CONCLUSIONS

We present a first description of IgG4-RD in a patient with Wells syndrome and the ninth case of IgG4-RD in a scrotal organ, and discuss this very rare entity with reference to the literature.

VIRTUAL SLIDES

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_225.

摘要

背景

我们报告一例33岁男性患者，其在口服皮质类固醇治疗伴嗜酸性粒细胞增多的蜂窝织炎（即Wells综合征）期间，在左侧睾丸旁区域形成了免疫球蛋白（Ig）G4相关疾病（IgG4-RD）假瘤。

病例介绍

该患者从一家私立医院转诊至我院，有3个月无症状左侧阴囊肿块病史。左侧阴囊可触及一个直径5厘米的结节。计算机断层扫描和磁共振成像观察到左侧睾丸旁肿瘤病变累及附睾和精索。血液检查除C反应蛋白水平略有升高外无异常。尿液检查同样未发现明显异常。在诊断为疑似恶性肿瘤的左侧睾丸旁肿瘤后，进行了左侧根治性睾丸切除术。病理检查发现肿瘤为累及附睾和精索的左侧睾丸旁IgG4-RD。