Yanagisawa Hiroto, Mishima Keita, Yamanouchi Yaya, Ueda Yusuke, Yamano Takahiro, Iwao-Kawanami Haruka, Sakai Tomoyuki, Kawanami Takafumi, Yamada Kazunori, Kawano Mitsuhiro, Mizuta Shuichi, Fukushima Toshihiro, Masaki Yasufumi
Department of Hematology & Immunology, Kanazawa Medical University, Japan.
Intern Med. 2025 Mar 15;64(6):953-957. doi: 10.2169/internalmedicine.4010-24. Epub 2024 Aug 8.
A 77-year-old man presented with right inguinal lymphadenopathy and swollen parotid and submandibular glands bilaterally. Histopathology revealed germinal center B-cell type diffuse large B-cell lymphoma (DLBCL) in the inguinal lymph node. Lymphocyte and plasma cell infiltration in the submandibular gland with elevated serum IgG4 levels (13 g/L) prompted a diagnosis of IgG4-related disease (IgG4-RD). Systemic chemotherapy for DLBCL led to shrinkage of the lymph nodes and disappearance of the submandibular gland swelling, as confirmed by fluorodeoxyglucose-positron emission tomography/computed tomography. Although concomitant IgG4-RD and lymphoma have been reported, their simultaneous diagnosis is rare; therefore, a biopsy of all involved organs is crucial in cases with unusual organ involvement.
一名77岁男性患者出现右侧腹股沟淋巴结病，双侧腮腺和颌下腺肿大。组织病理学显示腹股沟淋巴结为生发中心B细胞型弥漫性大B细胞淋巴瘤（DLBCL）。颌下腺淋巴细胞和浆细胞浸润，血清IgG4水平升高（13g/L），提示诊断为IgG4相关性疾病（IgG4-RD）。氟脱氧葡萄糖-正电子发射断层扫描/计算机断层扫描证实，DLBCL的全身化疗导致淋巴结缩小，颌下腺肿胀消失。虽然已有IgG4-RD与淋巴瘤并存的报道，但同时诊断极为罕见；因此，对于器官受累情况异常的病例，对所有受累器官进行活检至关重要。
