Related Experiment Video
Updated: Apr 27, 2026
09:17
Point-of-Care Lung Ultrasound in Adults: Image Acquisition
Published on: March 3, 2023
9.2K
IgG4-related pleural disease presenting as a massive bilateral effusion
Atsuko Ishida1, Naoki Furuya, Takashi Nishisaka
1*Department of Internal Medicine, Division of Respiratory and Infectious Diseases, St Marianna University School of Medicine, Kawasaki †Department of Pathology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Journal of Bronchology & Interventional Pulmonology
|July 4, 2014
Summary
This case study identifies IgG4-related disease as a cause of pleural effusion. It highlights the importance of considering IgG4-related disease in unexplained pleuritis diagnoses.
Area of Science:
- Immunology
- Pulmonology
- Pathology
Background:
- Pleural effusion is a common clinical problem with diverse etiologies.
- Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition that can affect various organs.
Observation:
- A 74-year-old woman presented with massive, exudative pleural effusion and mononuclear cell predominance.
- Parietal pleura showed thickening and reddish discoloration, with biopsy revealing lymphoplasmacytic inflammation and fibrosis.
Findings:
- Immunohistochemical staining of pleural biopsy demonstrated 91 IgG4-positive plasma cells/high-power field and an IgG4/IgG ratio of 91%.
- These findings confirmed the diagnosis of pleuritis secondary to IgG4-related disease.
Implications:
- This case suggests IgG4-related disease should be considered in the differential diagnosis of unexplained pleural effusions.
- Early recognition and diagnosis of IgG4-related pleuritis can guide appropriate management strategies.
Related Concept Videos
01:25Pleural Effusion I: Introduction
6.2K
Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
6.2K
01:28Pleural Effusion II: Symptoms and Management
1.4K
Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
1.4K
01:27Pneumothorax-II
1.7K
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
1.7K
01:18Pulmonary Edema II: Pathophysiology
26
Pulmonary edema is the accumulation of fluid in the interstitial and alveolar spaces of the lungs, impairing gas exchange and oxygen delivery. It may be cardiogenic or noncardiogenic, but both reduce oxygenation and lung compliance.Cardiogenic Pulmonary EdemaCardiogenic edema results from increased hydrostatic pressure in pulmonary capillaries, usually due to left ventricular dysfunction from myocardial infarction, heart failure, or valvular disease. Ineffective cardiac pumping causes blood to...
26
01:31Pulmonary Tuberculosis III
1.7K
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
1.7K
01:08Pneumothorax II: Pathophysiology
43
Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance...
43