Ocular adnexal IgG4-producing mucosa-associated lymphoid tissue lymphoma mimicking IgG4-related disease

J Clin Exp Hematop. 2012;52(1):51-5. doi: 10.3960/jslrt.52.51.

Abstract

IgG4-related disease is a recently proposed clinical entity with several unique clinicopathological features. A chronic inflammatory state with marked fibrosis, which can often be mistaken for malignancy, especially by clinical imaging analyses, unifies these features. In the present report, we describe a case of IgG4-producing mucosa-associated lymphoid tissue lymphoma mimicking IgG4-related disease. The patient was a 55-year-old male who was being followed for right orbital tumor over 1.5 years. The lesion had recently increased in size, so a biopsy was performed. Histologically, the lesion was consistent with IgG4-related disease ; however, IgG4+ plasma cells showed immunoglobulin light-chain restriction and immunoglobulin heavy chain gene rearrangement was detected in the lesion. Therefore, the lesion was diagnosed as IgG4-producing mucosa-associated lymphoid tissue lymphoma. In conclusion, in histological diagnosis of IgG4-related disease, it is important to examine not only IgG4-immunostain but also immunoglobulin light-chain restriction.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Dacryocystitis* / metabolism
  • Dacryocystitis* / pathology
  • Diagnosis, Differential
  • Eye Neoplasms* / metabolism
  • Eye Neoplasms* / pathology
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunoglobulin G / biosynthesis*
  • Lymphoma, B-Cell, Marginal Zone* / metabolism
  • Lymphoma, B-Cell, Marginal Zone* / pathology
  • Male
  • Middle Aged
  • Mikulicz' Disease* / metabolism
  • Mikulicz' Disease* / pathology
  • Neoplasm Proteins / biosynthesis*

Substances

  • Immunoglobulin G
  • Neoplasm Proteins