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伴有肺部病变和复发性胸腔积液的IgG4相关性肺病:一例报告

IgG4-related lung disease with pulmonary lesions and recurrent pleural effusion: A case of report.

作者信息

Xia Ning, Wang Wei, Zhang Wei, Li Yan, Nie Xiu-Hong

机构信息

Department of Respiratory Disease, Xuanwu Hospital, Capital Medical University, Beijing, PR China.

Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, PR China.

出版信息

Radiol Case Rep. 2025 May 15;20(8):3820-3825. doi: 10.1016/j.radcr.2025.04.028. eCollection 2025 Aug.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48ae/12143773/426218ee856a/gr1.jpg

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