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福島医学会 = The Fukushima Society of Medical Science >
福島医学雑誌 = Fukushima Medical Journal >
Vol.72 (2022) >
No.2 (2022) >

Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/1880

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Title: 組織生検で診断に至ったIgG4関連後腹膜線維症の1例
Other Titles: A case of IgG4-related retroperitoneal fibrosis diagnosed by tissue biopsy
Authors: 中田, 敬
熊谷, 伸
村木, 修
鈴木, 修三
Source title: 福島医学雑誌
Volume: 72
Issue: 2
Start page: 65
End page: 71
Issue Date: 2022
Abstract: 症例は82歳男性。2020年12月,右腰背部痛を主訴に近医受診。腹部CTにて右腎門部に不整形腫瘤を認め精査加療目的に当科に紹介された。当科で施行した腹部CT,逆行性腎盂造影,および尿細胞診で腎あるいは尿路由来の悪性疾患の診断には至らなかったことから,後腹膜線維症が疑われた。血清IgGおよびIgG4の高値を認めたため,診断確定をするためにエコーガイド下生検を施行した。病理組織ではびまん性のリンパ球集簇と線維化が見られた。またIgG4陽性形質細胞の浸潤を認め,IgG4/IgG陽性細胞比が40%以上に増加していたことからIgG4関連後腹膜線維症と診断した。プレドニゾロン20 mg/dayの投与を行ったところ,右腎門部腫瘤の縮小と血清IgG4値の低下を認めた。
An 82-year-old man presented to our department in December 2020 with a complaint of right lumbar back pain. An abdominal computed tomography showed an irregular mass at the right renal hilum. The abdominal CT, retrograde pyelography, and urine cytology did not reveal a renal or urinary tract malignancy, and retroperitoneal fibrosis was also suspected. An echo-guided biopsy was performed to confirm the diagnosis because of high levels of serum IgG and IgG4. The histopathological specimens showed diffuse lymphocyte aggregation and fibrosis. The patient was diagnosed as having IgG4-related retroperitoneal fibrosis because the IgG4/IgG-positive cell ratio increased to 40 or more. After treatment with prednisolone 20 mg/day, the right hilar mass shrank and the serum IgG4 level decreased.
Publisher: 福島医学会
language: jpn
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/1880
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/1880/1/FksmMedJ_72_p65.pdf
ISSN: 0016-2582
DOI: 10.5387/fmedj.72.2_65
Related Page: https://doi.org/10.5387/fmedj.72.2_65
Rights: © 2022 福島医学会
Appears in Collections:No.2 (2022)

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