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Mind the gap: IgG4-related disease mimicking infectious cerebral mass lesions

Andrea De Maria1,2, Chiara Sepulcri3, Stefania Tutino3

  • 1Clinica Malattie Infettive e Tropicali, DISSAL, University of Genoa, Largo R.Benzi 10, 16124, Genoa, Italy. De-maria@unige.it.

European Journal of Medical Research
|March 20, 2022
PubMed

Insights

IgG4-related disease can mimic brain tumors and infections. This case highlights the importance of considering IgG4-related disease in the differential diagnosis of cerebral masses.

Area of Science:

  • Neurology
  • Immunology
  • Pathology

Background:

  • Cerebral intraparenchymal masses typically prompt evaluation for neoplastic or infectious causes.
  • Diagnostic challenges arise when initial workups for common etiologies are inconclusive.

Observation:

  • An 82-year-old male presented with seizures and cerebral masses, with a history of treated tuberculosis.
  • Extensive workup excluded infectious and primary neoplastic origins.
  • Histopathological examination of a resected lesion revealed IgG4-related disease.

Findings:

  • The resected mass showed histiocytic granulomatous tissue with a significant IgG4-positive plasma cell component.
  • The patient showed marked improvement following corticosteroid treatment.

Implications:

  • IgG4-related disease should be considered in the differential diagnosis of single or multiple cerebral masses.
  • This expands the known spectrum of IgG4-related disease presentations.
  • Early recognition and treatment can lead to favorable patient outcomes.
Abstract

Keywords:
AbscessCNS massCerebralIgG4IgG4-related diseaseMRI

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