通过胸腔镜胸膜活检确诊的 IgG4 相关胸膜疾病:病例报告。

IF 0.8 Q4 RESPIRATORY SYSTEM
Respirology Case Reports Pub Date : 2024-07-30 eCollection Date: 2024-08-01 DOI:10.1002/rcr2.1442
Azusa Miyoshi, Hideki Katsura, Tomohiro Akaba, Mitsuko Kondo, Etsuko Tagaya
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引用次数: 0

摘要

我们在此报告一例罕见的免疫球蛋白 G4(IgG4)相关胸膜疾病病例,该病例是通过胸腔镜胸膜活检确诊的。一名 66 岁的男性因右侧双侧胸腔积液和逐渐加重的呼吸困难入住我院。胸片显示右侧胸腔积液,胸部计算机断层扫描显示双侧胸腔积液,但无实质病变。虽然双侧胸腔积液呈渗出性,且淋巴细胞数量增多,但起初无法明确诊断。血清和胸腔积液中的 IgG4 水平很高。通过视频辅助胸腔镜手术采集的右侧胸膜活检标本的病理评估显示,纤维化相关淋巴浆细胞浸润,每个高倍视野有 45-60 个 IgG4 阳性浆细胞,IgG4/免疫球蛋白 G 的比率为 40%。因此,患者被诊断为 IgG4 相关性胸膜疾病。经过皮质类固醇治疗后,双侧胸腔积液有所好转。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
IgG4-related pleural disease diagnosed by thoracoscopic pleural biopsy: A case report.

Here we report a rare case of immunoglobulin G4 (IgG4)-related pleural disease diagnosed using a thoracoscopic pleural biopsy. A 66-year-old man was admitted to our hospital with right-dominant bilateral pleural effusions and gradually worsening dyspnoea. Chest radiographs revealed right-dominant pleural effusions, while chest computed tomography showed bilateral pleural effusions without parenchymal lesions. Although the bilateral pleural effusions were exudative with an increased number of lymphocytes, the definitive diagnosis was initially elusive. High IgG4 levels in the serum and pleural effusions were observed. A pathological evaluation of a right pleural biopsy specimen collected via video-assisted thoracoscopic surgery showed fibrosis-associated lymphoplasmacytic infiltration, 45-60 IgG4-positive plasma cells per high-power field, and an IgG4/immunoglobulin G ratio of 40%. Consequently, the patient was diagnosed with IgG4-related pleural disease. The bilateral pleural effusions improved after corticosteroid therapy.

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来源期刊
Respirology Case Reports
Respirology Case Reports RESPIRATORY SYSTEM-
CiteScore
1.40
自引率
0.00%
发文量
178
审稿时长
8 weeks
期刊介绍: Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.
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