Murata Shiori, Inoue Koji, Makita Noriyuki, Suzuki Issei, Kubota Masashi, Tohi Yoichiro, Sugino Yoshio, Kawakita Mutsushi
Department of Urology Kobe City Medical Center General Hospital Kobe Hyogo Japan.
IJU Case Rep. 2021 Jun 8;4(5):282-284. doi: 10.1002/iju5.12325. eCollection 2021 Sep.
Immunoglobulin G4-related disease is a systemic disease characterized by multifocal systemic involvement. We report two cases of women diagnosed with immunoglobulin G4-related disease in the urethra.
Case 1: A 67-year-old woman presented with discomfort around her perineum. Magnetic resonance imaging revealed a well-defined mass around the urethra. She underwent an ultrasound-guided core needle biopsy of the mass. The pathologic specimen showed immunoglobulin G4 positive cells. Steroid therapy was initiated, causing improvement of symptoms, decreased serum immunoglobulin G4 levels, and shrinking of the mass. Case 2: An 89-year-old woman was accidentally diagnosed with renal pelvic wall thickening on computed tomography. The pathologic specimen captured by ultrasound-guided needle biopsy showed immunoglobulin G4 positive cells. She had no symptoms and received no medical treatment.
The frequency of urethral mass formation in female patients with immunoglobulin G4-related disease may also be high, and an echo-guided transvaginal urethral biopsy may be performed as a definitive diagnostic tool for immunoglobulin G4-related disease.
免疫球蛋白G4相关疾病是一种以多灶性全身受累为特征的全身性疾病。我们报告两例女性患者被诊断为尿道免疫球蛋白G4相关疾病。
病例1：一名67岁女性出现会阴部不适。磁共振成像显示尿道周围有边界清晰的肿块。她接受了超声引导下肿块的粗针穿刺活检。病理标本显示免疫球蛋白G4阳性细胞。开始使用类固醇治疗，症状改善，血清免疫球蛋白G4水平降低，肿块缩小。病例2：一名89岁女性在计算机断层扫描时意外诊断出肾盂壁增厚。超声引导下针吸活检获取的病理标本显示免疫球蛋白G4阳性细胞。她没有症状，未接受治疗。
免疫球蛋白G4相关疾病女性患者尿道肿块形成的发生率可能也很高，经阴道超声引导下尿道活检可作为免疫球蛋白G4相关疾病的确定性诊断工具。
