头颈部肿块样纤维炎性病变，类似 IgG4 相关疾病。
A Tumefactive Fibroinflammatory Lesion of the Head and Neck Mimicking Immunoglobulin G4-related Disease.
机构信息
Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Japan.
Department of Anatomic Pathology, Kurashiki Central Hospital, Japan.
出版信息
Intern Med. 2023 Feb 15;62(4):637-641. doi: 10.2169/internalmedicine.9760-22. Epub 2022 Jul 29.
A 67-year-old woman with a 5-year history of recurrent swollen eyelids and epistaxis, diagnosed as immunoglobulin G4-related diseases (IgG4-RD) based on hyper-IgG4-emia and IgG4-positive cell infiltration to the lesion, was referred to our department due to recurrent symptoms despite corticosteroid therapies. Computed tomography revealed an osteoclastic sinus mass with prominent neutrophil infiltration and necrosis that was incompatible with IgG4-RD histopathologically. Finally, she was diagnosed with a tumefactive fibroinflammatory lesion (TFIL) of the head and neck and treated with high-dose corticosteroids. Physicians should remember that TFIL can mimic IgG4-RD in the head and neck region with prominent neutrophil infiltration and necrosis.
一位 67 岁女性，5 年来反复发作的眼睑肿胀和鼻出血，根据高免疫球蛋白 G4-血症和病变部位 IgG4 阳性细胞浸润，诊断为 IgG4 相关疾病（IgG4-RD），尽管接受了皮质类固醇治疗，但仍有复发症状，故转至我科就诊。计算机断层扫描显示破骨细胞性鼻窦肿块，伴有明显的中性粒细胞浸润和坏死，与 IgG4-RD 的组织病理学表现不符。最后，她被诊断为头颈部肿块样纤维炎症性病变（TFIL），并接受了大剂量皮质类固醇治疗。医生应记住，TFIL 可在头颈部区域伴有明显中性粒细胞浸润和坏死的情况下模仿 IgG4-RD。
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