Mochizuki Kunio, Hanai Yuki, Nakazawa Kumiko, Murata Shiori, Kasai Kazuki, Mochizuki Naoko, Tahara Ippei, Kondo Tetsuo
Department of Pathology, School of Medicine, University of Yamanashi, Yamanashi, Japan.
Department of Pathology, University of Yamanashi Hospital, Yamanashi, Japan.
Diagn Cytopathol. 2019 Feb;47(2):130-133. doi: 10.1002/dc.24099. Epub 2018 Oct 30.
IgG4-related disease (IgG4-RD) can affect various organs, and the pancreas and salivary gland are representative examples. We report a rare case of IgG4-RD of the paratestis. A 74-year-old man presented with left scrotal swelling. Scrotopuncture drainage and cytology confirmed a clear, yellow retention liquid (130 mL) with many small, similar lymphocytes and a few plasmacytes. Many lymphoid cells were immunopositive for CD3 on a cell block section, indicating that a predominant type of lymphoid cells was T cell. There were also some CD20 immunopositive cells and a few IgG4 immunopositive cells. Two months later the left scrotal swelling had returned, and he underwent radical inguinal orchiectomy. Microscopically, there was considerable lymphoplasmacytic inflammatory infiltration, fibrosis and abundant IgG4 immunopositive cells in the paratesticular region. The histopathologic and immunohistochemistry findings were consistent with IgG4-RD. However, the abundant T cells in the scrotal fluid complicated the cytological diagnosis in our case.
IgG4相关性疾病（IgG4-RD）可累及多个器官，胰腺和唾液腺是其典型代表。我们报告一例罕见的睾丸旁组织IgG4-RD病例。一名74岁男性因左侧阴囊肿胀就诊。阴囊穿刺引流及细胞学检查证实为清亮的黄色潴留液（130毫升），其中有许多形态相似的小淋巴细胞及少量浆细胞。在细胞块切片上，许多淋巴细胞CD3免疫阳性，表明主要淋巴细胞类型为T细胞。也有一些CD20免疫阳性细胞及少量IgG4免疫阳性细胞。两个月后左侧阴囊肿胀复发，遂行根治性腹股沟睾丸切除术。显微镜下，睾丸旁区域有大量淋巴浆细胞炎性浸润、纤维化及丰富的IgG4免疫阳性细胞。组织病理学及免疫组化结果符合IgG4-RD。然而，本病例阴囊液中大量T细胞使细胞学诊断复杂化。
