具有囊性特征的免疫球蛋白G4相关性炎性假瘤酷似肾癌。
Immunoglobulin G4-Related Inflammatory Pseudotumor With Cystic Features Mimicking Renal Cancer.
作者信息
Tanaka Yuki, Yamashita Takahisa, Yokota Kazuki, Fujii Kenta, Kitayama Sachi, Nagamoto Shoichi, Takeshita Hideki, Okada Yohei, Kawakami Satoru, Yano Akihiro
机构信息
Department of Urology Saitama Medical Center, Saitama Medical University Kawagoe Japan.
Department of Pathology Saitama Medical Center, Saitama Medical University Kawagoe Japan.
出版信息
IJU Case Rep. 2025 Jul 27;8(5):489-493. doi: 10.1002/iju5.70074. eCollection 2025 Sep.
INTRODUCTION
Immunoglobulin G4-related disease is a systemic fibroinflammatory disorder that affects the kidney, presenting as an immunoglobulin G4-related inflammatory pseudotumor. These renal inflammatory pseudotumors are usually solid, and cystic presentations have not been previously described.
CASE PRESENTATION
We report a 77-year-old man who presented with a Bosniak category III renal cystic mass and periaortic fibrous thickening. Increased serum immunoglobulin G4 levels indicated immunoglobulin G4-related disease; however, a malignant process could not be definitively ruled out. The patient underwent robot-assisted radical nephrectomy, and histopathologic assessment confirmed a cystic immunoglobulin G4-related inflammatory pseudotumor.
CONCLUSION
This is the first report of a renal immunoglobulin G4-related inflammatory pseudotumor with cystic features. Increased knowledge of immunoglobulin G4-related disease as a potential cause of cystic renal lesions, particularly in patients with systemic findings, may improve preoperative diagnosis.
引言
免疫球蛋白G4相关性疾病是一种全身性纤维炎症性疾病，可累及肾脏，表现为免疫球蛋白G4相关性炎性假瘤。这些肾脏炎性假瘤通常为实性，此前尚未有囊性表现的报道。
病例报告
我们报告一名77岁男性，其表现为博斯尼亚克III类肾囊性肿块和主动脉周围纤维增厚。血清免疫球蛋白G4水平升高提示免疫球蛋白G4相关性疾病；然而，不能完全排除恶性病变。患者接受了机器人辅助根治性肾切除术，组织病理学评估证实为囊性免疫球蛋白G4相关性炎性假瘤。
结论
这是首例具有囊性特征的肾脏免疫球蛋白G4相关性炎性假瘤报告。提高对免疫球蛋白G4相关性疾病作为囊性肾病变潜在病因的认识，尤其是在有全身表现的患者中，可能会改善术前诊断。
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