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Immunoglobulin G4-Related Lymphadenopathy
Christine E Bookhout1, Marian A Rollins-Raval1
1Department of Pathology and Laboratory Medicine, University of North Carolina, Campus Box 7525, Brinkhous-Bullitt Building, Chapel Hill, NC 27599-7525, USA.
Surgical Pathology Clinics
|March 5, 2016
Summary
Immunoglobulin G4-related lymphadenopathy (IgG4-RLAD) is a challenging diagnosis due to varied microscopic patterns. Early recognition of IgG4-related lymphadenopathy is crucial for effective immunotherapy.
Area of Science:
- Immunopathology
- Oncology
- Rheumatology
Background:
- Immunoglobulin G4-related disease (IgG4-RD) is a multi-system immune-mediated condition.
- IgG4-related lymphadenopathy (IgG4-RLAD) is an extranodal manifestation of IgG4-RD.
- IgG4-RLAD presents diagnostic challenges due to diverse microscopic patterns.
Purpose of the Study:
- To highlight the diagnostic challenges of IgG4-related lymphadenopathy.
- To emphasize the importance of recognizing IgG4-RLAD in clinical practice.
- To underscore the need for including IgG4-RLAD in the differential diagnosis.
Main Methods:
- Review of histopathologic features of IgG4-related lymphadenopathy.
- Analysis of morphologic variability in lymph node biopsies.
- Comparison of IgG4-RLAD with extranodal IgG4-RD manifestations.
Main Results:
- Five distinct microscopic patterns of IgG4-RLAD have been described.
- Many IgG4-RLAD patterns mimic reactive lymphoid hyperplasia.
- Morphologic variability complicates accurate diagnosis.
Conclusions:
- Histologic recognition of IgG4-RLAD is vital due to its potential responsiveness to immunotherapy.
- IgG4-RLAD should be considered in the differential diagnosis of lymphadenopathy.
- Accurate diagnosis of IgG4-RLAD facilitates appropriate patient management.
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