Vol.22 No.5

Case Report

An immunoglobulin G4-related disease mimicking postoperative lung cancer recurrence

Authors

Seshiru Nakazawa1 , Kimihiro Shimizu1 , Tetsuhiro Nakano1 , Seiichi Kakegawa1 , Jun Atsumi1 , Mitsuhiro Kamiyoshihara1 , Junko Hirato2 , Izumi Takeyoshi1

  • Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
  • Department of Pathology, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
Received:

29 July 2011

Accepted:

11 December 2011

Published online:

5 January 2012

Full Text

PDF　(member's only)

Abstract

A postoperative lung cancer patient presented with lymphadenopathy, pleural thickening, and 18F-fluorodeoxyglucose (FDG) uptake on a positron emission tomography-computed tomography (PET-CT) scan. Lung cancer recurrence was initially suspected, but bilateral submandibular masses with 18F-FDG uptake indicated the possibility of a systemic disease, such as Mikulicz’s disease. High serum immunoglobulin G4 (IgG4) and IgG4-positive plasma cell infiltration in the submandibular glands led to the diagnosis of IgG4-related disease. After systemic steroid therapy, 18F-FDG uptake decreased in both the submandibular glands and the suspected recurrent lesions.

Key words

Immunoglobulin G4-related disease - Lung cancer recurrence - Mikulicz’s disease - Non-small-cell lung cancer - Positron emission tomography and computed tomography