Mori Shigeo, Tahashi Yoshiya, Uchida Kazushige, Ikeura Tsukasa, Danbara Naoyuki, Wakamatsu Takahiro, Kusuda Takeo, Takahashi Yu, Yanagawa Masato, Matsushita Mitsunobu, Ohe Chisato, Michiura Taku, Inoue Kentaro, Kon Masanori, Okazaki Kazuichi
Third Department of Internal Medicine, Kansai Medical University, Japan.
Department of Pathology and Laboratory Medicine, Kansai Medical University, Japan.
Intern Med. 2017 Nov 15;56(22):3023-3026. doi: 10.2169/internalmedicine.8095-16. Epub 2017 Oct 11.
The patient was a 76-year-old woman who had noticed slight difficulty in swallowing in the 3 years prior to this presentation. Her dysphagia progressed while she was hospitalized following cervical cancer surgery. Esophagogastroduodenoscopy and an esophagram showed circumferential erosion and a stricture of the thoracic esophagus. Esophageal resection was performed; the resected specimens showed a stricture and wall thickening. Histologically, transmural hyperplasia, which consisted of inflammatory granulation tissue with the abundant infiltration of IgG4-positive plasma cells and lymphocytes, was observed. The patient was diagnosed with probable IgG4-related disease. IgG4-related esophageal disease presenting as esophageal lesions alone is a very rare condition.
该患者为一名76岁女性，在此次就诊前3年就已注意到吞咽时有轻微困难。在她因宫颈癌手术住院期间，吞咽困难症状加重。食管胃十二指肠镜检查和食管造影显示胸段食管出现环形糜烂和狭窄。遂进行了食管切除术；切除标本显示有狭窄和管壁增厚。组织学检查发现透壁性增生，由炎症性肉芽组织组成，伴有大量IgG4阳性浆细胞和淋巴细胞浸润。该患者被诊断为可能患有IgG4相关疾病。仅表现为食管病变的IgG4相关食管疾病是一种非常罕见的病症。
