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[A case of IgG4-positive inflammatory pseudotumor which rapidly resolved]
Kentaro Sakashita1, Mikio Takamori, Kengo Murata
1Department of Respiratory Medicine, Tokyo Metropolitan Tama Medical Center.
Insights
This case study presents a rare instance of spontaneous remission in a patient with inflammatory pseudotumor of the lung. Researchers speculate a link between IgG4 and this unexpected recovery, offering new insights into lung tumor resolution.
Area of Science:
- Pulmonology
- Pathology
- Immunology
Background:
- Inflammatory pseudotumor of the lung is a rare condition.
- Spontaneous remission is uncommon but has been reported in related IgG4-related sclerosing diseases.
Observation:
- A 72-year-old man presented with cough, fever, and weight loss, showing a lung tumor on X-ray.
- Biopsy confirmed inflammatory pseudotumor with specific cellular infiltrates.
- Symptoms and tumor resolved spontaneously within four weeks.
Findings:
- The patient experienced complete resolution of symptoms and the pulmonary tumor.
- Histopathological findings were consistent with inflammatory pseudotumor.
- No recurrence was observed during follow-up.
Implications:
- This case suggests a potential role for IgG4 in the spontaneous remission of pulmonary inflammatory pseudotumor.
- Further research into IgG4-related sclerosing disease may elucidate mechanisms of tumor regression.
- Highlights the possibility of non-surgical resolution for certain lung lesions.
Abstract:
A 72-year-old man visited our hospital due to persistent cough, fever and weight loss. A chest X-ray film revealed a round tumor in the left lower lung field. A specimen obtained by transbronchial lung biopsy demonstrated histiocytic and lymphocytic infiltration in the alveolar space, with spindle myofibroblasts and plasmacytes in the interstitium, Those findings were consistent with inflammatory pseudotumor. Four weeks later, a chest X-ray film showed only scars of the primary lesion, and his symptoms resolved dramatically. He has had no recurrence of symptoms and pulmonary tumor since then. Although spontaneous remission is uncommon in inflammatory pseudotumor of the lung, there are several case reports about spontaneous remission of hepatic inflammatory pseudotumor and autoimmune pancreatitis, parts of IgG4-related sclerosing disease. Recently, inflammatory pseudotumor is thought to be IgG4-related sclerosing disease. We speculate that IgG4 may be associated with spontaneous remission of inflammatory pseudotumor of the lung, and we discuss this issue in relation to the pertinent literature.
