Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized disease characterized by elevated serum IgG4 levels, tissue infiltration rich in IgG4+ plasma cells. We report on a case which was first considered as pseudolymphoma from the histopathological analysis, but finally diagnosed as IgG4-related skin lesions. As the morphological features of cutaneous involvement of IgG4-RD are consistent with those of cutaneous pseudolymphoma, we tried immunostaining past potential cases of IgG4-RD. Thirty-two skin specimens (15 men and 17 women; mean age, 53 years) diagnosed as having pseudolymphoma were retrieved from the archives to conduct hematoxylin-eosin, IgG and IgG4 staining. Out of the 32 cases of cutaneous pseudolymphoma, germinal center formation was seen in 22 cases, and moderate-severe fibrosis was seen in seven cases. Eleven cases showed more than 10 IgG4+ plasma cell infiltration/high-power field, and among these 11 cases, seven cases (22%) showed A ratio of IgG4+/IgG+ cells of more than 40%. Thus, out of the 32 cases of cutaneous pseudolymphomas, two cases (6.3%) satisfied IgG4-RD histopathological diagnostic criteria. As clinical presentations and histopathological features of skin involvement of IgG4-RD are analogous to cutaneous B-cell pseudolymphoma, careful identification is required through systemic examination, serum IgG4 measurement and other means.
| Original language | English |
|---|---|
| Pages (from-to) | 998-1003 |
| Number of pages | 6 |
| Journal | Journal of Dermatology |
| Volume | 40 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 01-12-2013 |
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All Science Journal Classification (ASJC) codes
- Dermatology
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Case of immunoglobulin G4-related skin disease : Possible immunoglobulin G4-related skin disease cases in cutaneous pseudolymphoma only by immunohistochemical analysis. / Iwata, Yohei; Mizoguchi, Yoshikazu; Takahashi, Masayuki; Tanaka, Beni; Kuroda, Makoto; Yagami, Akiko; Matsunaga, Kayoko.
In: Journal of Dermatology, Vol. 40, No. 12, 01.12.2013, p. 998-1003.Research output: Contribution to journal › Article
TY - JOUR
T1 - Case of immunoglobulin G4-related skin disease
T2 - Possible immunoglobulin G4-related skin disease cases in cutaneous pseudolymphoma only by immunohistochemical analysis
AU - Iwata, Yohei
AU - Mizoguchi, Yoshikazu
AU - Takahashi, Masayuki
AU - Tanaka, Beni
AU - Kuroda, Makoto
AU - Yagami, Akiko
AU - Matsunaga, Kayoko
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized disease characterized by elevated serum IgG4 levels, tissue infiltration rich in IgG4+ plasma cells. We report on a case which was first considered as pseudolymphoma from the histopathological analysis, but finally diagnosed as IgG4-related skin lesions. As the morphological features of cutaneous involvement of IgG4-RD are consistent with those of cutaneous pseudolymphoma, we tried immunostaining past potential cases of IgG4-RD. Thirty-two skin specimens (15 men and 17 women; mean age, 53 years) diagnosed as having pseudolymphoma were retrieved from the archives to conduct hematoxylin-eosin, IgG and IgG4 staining. Out of the 32 cases of cutaneous pseudolymphoma, germinal center formation was seen in 22 cases, and moderate-severe fibrosis was seen in seven cases. Eleven cases showed more than 10 IgG4+ plasma cell infiltration/high-power field, and among these 11 cases, seven cases (22%) showed A ratio of IgG4+/IgG+ cells of more than 40%. Thus, out of the 32 cases of cutaneous pseudolymphomas, two cases (6.3%) satisfied IgG4-RD histopathological diagnostic criteria. As clinical presentations and histopathological features of skin involvement of IgG4-RD are analogous to cutaneous B-cell pseudolymphoma, careful identification is required through systemic examination, serum IgG4 measurement and other means.
AB - Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized disease characterized by elevated serum IgG4 levels, tissue infiltration rich in IgG4+ plasma cells. We report on a case which was first considered as pseudolymphoma from the histopathological analysis, but finally diagnosed as IgG4-related skin lesions. As the morphological features of cutaneous involvement of IgG4-RD are consistent with those of cutaneous pseudolymphoma, we tried immunostaining past potential cases of IgG4-RD. Thirty-two skin specimens (15 men and 17 women; mean age, 53 years) diagnosed as having pseudolymphoma were retrieved from the archives to conduct hematoxylin-eosin, IgG and IgG4 staining. Out of the 32 cases of cutaneous pseudolymphoma, germinal center formation was seen in 22 cases, and moderate-severe fibrosis was seen in seven cases. Eleven cases showed more than 10 IgG4+ plasma cell infiltration/high-power field, and among these 11 cases, seven cases (22%) showed A ratio of IgG4+/IgG+ cells of more than 40%. Thus, out of the 32 cases of cutaneous pseudolymphomas, two cases (6.3%) satisfied IgG4-RD histopathological diagnostic criteria. As clinical presentations and histopathological features of skin involvement of IgG4-RD are analogous to cutaneous B-cell pseudolymphoma, careful identification is required through systemic examination, serum IgG4 measurement and other means.
UR - http://www.scopus.com/inward/record.url?scp=84890427029&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890427029&partnerID=8YFLogxK
U2 - 10.1111/1346-8138.12301
DO - 10.1111/1346-8138.12301
M3 - Article
C2 - 24303847
AN - SCOPUS:84890427029
VL - 40
SP - 998
EP - 1003
JO - Journal of Dermatology
JF - Journal of Dermatology
SN - 0385-2407
IS - 12
ER -