Lung adenocarcinoma misdiagnosed as IgG4-related lung disease:A case report and literature review

VernacularTitle:误诊为IgG4相关性肺病的肺腺癌1例并文献复习
Author: Yingjiao LONG ¹ ; Xiaopeng LIU ; Yuqi ZHAO ; Jie QING ; Ke ZHANG ; Hong PENG
Author Information

1. 中南大学湘雅二医院呼吸与危重症医学科,长沙410011
Keywords: IgG4-related disease; IgG4-related lung disease; IgG4-positive plasma cell; lung adenocarcinoma
From: Journal of Central South University(Medical Sciences) 2021;46(7):767-773
CountryChina
Language:Chinese
Abstract: IgG4-related disease (IgG4-RD) is a recently recognized disorder characterized by elevated serum IgG4 levels and infiltration of IgG4 positive blood cells in the affected organs. However, other conditions like malignancy as well as connective tissue diseases, may show similar findings. A 56-year-old male patient visited Second Xiangya Hospital, Central South University for recurrent fever and chest pain for more than 1 month. Preliminary tests diagnosed as IgG4-related lung disease (IgG4-RLD). However, the improvement of symptoms was absent after the treatment with methylprednisolone. The patient underwent the second biopsy and the result eventually demonstrated lung adenocarcinoma. The role of IgG4 in the pathogenesis or prognosis for lung adenocarcinoma remains unclear. Therefore, a thorough evaluation of symptoms, test of specific serum markers and eventually pathological confirmation are required to avoid misdiagnosis.