模拟IgG4相关疾病的副肿瘤性慢性主动脉周围炎的组织学表现
Paraneoplastic Chronic Periaortitis with Histologic Findings Mimicking IgG4-related Disease.
文献信息
| PMID | 42749639 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ayane Goto |
| 作者单位 | Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan. |
| 期刊 | Internal medicine (Tokyo, Japan) |
| SCI 分区 | Q3 |
| IF | 1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
慢性主动脉周围炎通常为特发性，但也可能继发于恶性肿瘤或IgG4相关疾病（IgG4-RD）。我们报告一例56岁男性，因主动脉周围软组织增厚压迫喉返神经导致发声困难。组织学检查显示席纹状纤维化和淋巴浆细胞浸润，但血清IgG4水平未升高，IgG4阳性细胞也不丰富。影像学显示左侧颈总动脉进行性受累，FDG-PET显示局灶性摄取。随后在邻近淋巴结中发现转移性甲状腺乳头状癌。手术后，糖皮质激素治疗使主动脉周围炎改善。本病例突出了模拟IgG4-RD的副肿瘤性主动脉周围炎，以及当发现不明确时需要筛查恶性肿瘤。
英文摘要
Chronic periaortitis is usually idiopathic but may occur secondary to malignancy or IgG4-related disease (IgG4-RD). We report a case of a 56-year-old man with dysphonia caused by recurrent laryngeal nerve compression due to periaortic soft tissue thickening. A histological examination revealed storiform fibrosis and lymphoplasmacytic infiltration, but not elevated serum IgG4 levels or abundant IgG4-positive cells. Imaging revealed progressive involvement of the left common carotid artery, and FDG-PET showed a focal uptake. Metastatic papillary thyroid carcinoma was subsequently identified in the adjacent lymph nodes. Periaortitis improved with glucocorticoids after surgery. This case highlights paraneoplastic periaortitis mimicking IgG4-RD and the need to screen for malignancy when the findings are inconclusive.