在肺部IgG4阳性血细胞的差异诊断
1Department of Pathology, Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Avenue/L25, Cleveland, OH 44195, United States.
Seminars in diagnostic pathology
|November 22, 2023
概括
与免疫球蛋白G4相关的疾病 (IgG4-RD) 很少是肺部纤维炎性病变的原因. 许多疾病模仿IgG4-RD,需要仔细的病理评估,以避免误诊.
科学领域:
- 肺部病理学 肺部病理学
- 免疫病理学 免疫病理学
- 病理学 病理学 病理学
背景情况:
- 免疫球蛋白G4相关疾病 (IgG4-RD) 的识别扩展到包括呼吸道在内的各种器官.
- 最初的假设表明IgG4-RD是导致肺纤维炎性病变的原因.
- 病理学家在肺部活检中收到了更多的IgG4免疫组织化学要求.
研究的目的:
- 评估IgG4-RD在肺部疾病中的患病率和诊断准确度.
- 为了确定模仿肺部IgG4-RD的疾病.
- 引导病理学家诊断IgG4-RD及其模仿物.
主要方法:
- 文献和临床病例的审查,涉及肺部活检中的IgG4免疫组织化学.
- 在各种肺病理中分析IgG4阳性血细胞分布.
- 在疑似IgG4-RD病例中的临床和病理发现的比较.
主要成果:
- 阳性IgG4血细胞不特异于IgG4-RD,并且在其他肺部疾病中发现.
- 炎症性肌纤维细胞瘤和淋巴细胞增生等疾病显示IgG4血细胞.
- 在非IgG4-RD环境中,血清IgG4水平升高也可能发生.
- 肺部的真实IgG4-RD似乎比最初认为的少得多.
结论:
- IgG4-RD是肺部纤维炎性病变的不常见原因.
- 病理学家必须在肺部识别IgG4-RD的模仿者.
- 在将肺淋巴细胞透物归因于IgG4-RD之前,建议谨慎.
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