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Lymph node granulomas in immunoglobulin G4-related disease
Adrian C Bateman1, Margaret R Ashton-Key1, Sanjay Jogai1
1Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Histopathology
|January 27, 2015
Summary
Granulomas are an unusual finding in Immunoglobulin (Ig)G4-related disease (IgG4-RD). However, their presence in lymph nodes should not prevent diagnosis when clinicopathological features are consistent with IgG4-RD.
Area of Science:
- Pathology
- Immunology
- Rheumatology
Background:
- Immunoglobulin (Ig)G4-related disease (IgG4-RD) is a multisystem fibroinflammatory condition.
- Diagnosis relies on histopathological criteria including IgG4-positive plasma cells.
- Granulomas are typically absent and may deter diagnosis.
Observation:
- Two cases of IgG4-RD with concurrent granulomas in lymph nodes are presented.
- This represents a rare morphological variant of IgG4-RD.
- The presence of granulomas is an unusual but recognized feature.
Findings:
- Histopathological analysis revealed IgG4-RD features alongside granulomas.
- The IgG4-positive plasma cell marker and ratio were consistent with IgG4-RD.
- Morphological variations in IgG4-RD can occur.
Implications:
- The presence of granulomas should not exclude an IgG4-RD diagnosis.
- Consider IgG4-RD in cases with lymph node granulomas and compatible clinical findings.
- This finding expands the understanding of IgG4-RD's histopathological spectrum.
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