Xia Ning, Wang Wei, Zhang Wei, Li Yan, Nie Xiu-Hong
Department of Respiratory Disease, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, PR China.
Radiol Case Rep. 2025 May 15;20(8):3820-3825. doi: 10.1016/j.radcr.2025.04.028. eCollection 2025 Aug.
We report a rare case of IgG4-related lung disease (RLD) with pulmonary lesions and recurrent pleural effusion to improve the diagnosis and treatment of this disease. A 60-year-old man was admitted to hospital for cough and dyspnea. CT scan showed a right lower lobe intrapulmonary mass with unilateral right-sided pleural effusion. Histology revealed no malignant findings. After 1 year, the patient re-admitted to our hospital with high serum level of IgG4 and IgE concentrations. CT scan demonstrated partial resolution of intrapulmonary mass and right-sided pleural effusion, while concurrently revealing interval development of substantial left-sided pleural effusion. The patient was diagnosed with IgG4-RLD by biopsy finally. This is a first case report of IgG4-RLD with intrapulmonary lesions accompanied by asynchronous, rapidly accumulating bilateral pleural effusions. Clinicians should consider the possibility of IgG4-RLD with intrapulmonary lesions accompanied by asynchronous, rapidly growing bilateral pleural effusion, particularly after rigorously excluding common diseases.
我们报告一例罕见的IgG4相关性肺病(RLD),伴有肺部病变和反复胸腔积液,以提高对此疾病的诊断和治疗水平。一名60岁男性因咳嗽和呼吸困难入院。CT扫描显示右下叶肺内肿块伴右侧单侧胸腔积液。组织学检查未发现恶性病变。1年后,该患者因血清IgG4和IgE浓度升高再次入住我院。CT扫描显示肺内肿块和右侧胸腔积液部分消退,同时发现大量左侧胸腔积液在间隔期出现。最终通过活检诊断该患者为IgG4-RLD。这是首例伴有肺内病变且伴有异步、快速积聚的双侧胸腔积液的IgG4-RLD病例报告。临床医生应考虑伴有肺内病变且伴有异步、快速增长的双侧胸腔积液的IgG4-RLD的可能性,尤其是在严格排除常见疾病之后。