IgG4-related lung disease with a desquamative interstitial pneumonia pattern radiologically and pathologically. Issue 8 (1st August 2022)

• Record Type: Journal Article
• Authors: Tsuneyoshi, Shingo; Zaizen, Yoshiaki; Okamoto, Masaki; Hoshino, Tomoaki
• Is Part Of: BMJ case reports. Volume 15:Issue 8(2022)
• Publication Date: 2022-08-01
• Subjects: Respiratory medicine -- Interstitial lung disease; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2022-249998
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A man in his 60s exhibited persistent dry cough and dyspnoea, which persisted even after smoking cessation. Chest high-resolution CT showed diffuse ground-glass opacities in the subpleural areas of both lungs. He underwent bronchoscopy, but no definitive diagnosis could be made. Histopathological analysis of the specimen obtained by surgical lung biopsy showed a desquamative interstitial pneumonia (DIP) pattern, with lymphocyte and plasma cell infiltrates in the alveolar septa; the ratio of IgG and IgG4-positive cells was more than 90%. He quit smoking, but the radiological findings worsened. Based on the pathological findings, we diagnosed the patient with DIP due to IgG4-related lung disease. Prednisolone was initiated, and the symptoms and radiological findings improved.