IgG4-related Disease in the Stomach which Was Confused with Gastrointestinal Stromal Tumor (GIST): Two Case Reports and Review of the Literature.
- Author:
Ho Seok SEO
1
;
Yoon Ju JUNG
;
Cho Hyun PARK
;
Kyo Young SONG
;
Eun Sun JUNG
Author Information
- Publication Type:Case Report
- Keywords: Immunoglobulin G; Gastrointestinal stromal tumors
- MeSH: Biopsy; Diagnosis; Endoscopy; Female; Fibrosis; Gastrectomy; Gastrointestinal Stromal Tumors*; Humans; Immunoglobulin G; Immunoglobulins; Immunohistochemistry; Magnetic Resonance Imaging; Pathology; Purpura, Thrombocytopenic, Idiopathic; Splenectomy; Steroids; Stomach Neoplasms; Stomach*
- From:Journal of Gastric Cancer 2018;18(1):99-107
- CountryRepublic of Korea
- Language:English
- Abstract: Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40–50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration. She underwent a completion total gastrectomy with splenectomy for the gastric SET and ITP. The pathology showed storiform fibrosis, and IgG4 was positive in immunohistochemistry (IHC) stain. IgG4-RD is known as a medical disease that could be treated with oral steroids. The difficulty in preoperative diagnosis of the disease occasionally causes unnecessary gastric resection. Thus, preoperative diagnostic methods for IgG4-RD such as deep biopsy with IHC stain or magnetic resonance imaging are needed.
