A case of marginal zone B cell lymphoma mimicking IgG4-related dacryoadenitis and sialoadenitis

作者:Ohta Miho; Moriyama Masafumi*; Goto Yuichi; Kawano Shintaro; Tanaka Akihiko; Maehara Takashi; Furukawa Sachiko; Hayashida Jun Nosuke; Kiyoshima Tamotsu; Shimizu Mayumi; Arinobu Yojiro; Nakamura Seiji
来源:World Journal of Surgical Oncology, 2015, 13(1): 67.
DOI:10.1186/s12957-015-0459-z

摘要

Background: IgG4-related dacryoadenitis and sialoadenitis (IgG4-DS), so-called Mikulicz's disease, is characterized by elevated serum IgG4 and infiltration of IgG4-positive plasma cells in glandular tissues. Recently, several studies reported both malignant lymphoma developed on the background of IgG4-associated conditions and IgG4-producing malignant lymphoma (non-IgG4-related disease). Case presentation: We report on the case of a 70-year-old man who was strongly suspected IgG4-DS because of high serum IgG4 concentration (215 mg/dl) and bilateral swelling of parotid and submandibular glands. Biopsies of cervical lymph node and a portion of submandibular gland were performed. These histopathological findings subsequently confirmed a diagnosis of marginal zone B cell lymphoma. Conclusion: Differential diagnosis of IgG4-DS is necessary from other disorders, including Sjogren's syndrome, sarcoidosis, Castleman's disease, Wegener's granulomatosis, lymphoma, and cancer. We suggest that biopsy of swollen lesions is important for a definitive diagnosis of IgG4-DS and discuss the mechanism of development in this case.

  • 出版日期2015-2-21