A case of multiple immunoglobulin G4-related periarteritis: a tumorous lesion of the coronary artery and abdominal aortic aneurysm

Hum Pathol. 2008 Jun;39(6):975-80. doi: 10.1016/j.humpath.2007.10.023. Epub 2008 Apr 21.

Abstract

Immunoglobulin G4 (IgG4)-related disease can occur in various organs, most of which are glandular or ductal tissues. Here, we report a case of multiple IgG4-related vascular lesions. A 63-year-old patient was found to have an abdominal aortic aneurysm and a tumorous lesion around the right coronary artery. The surgically resected aneurysmal wall and a tumorous lesion of the right coronary artery showed similar histologic features including diffuse lymphoplasmacytic infiltration, occasional eosinophils, and obliterative phlebitis. Immunohistochemically, numerous IgG4-positive plasma cells were evident within the lesions. The serum concentrations of IgG4 in the preoperative period was 456 mg/dL (reference range, <135), which decreased to 242 mg/dL 2 weeks after surgery. We made a diagnosis of multiple IgG4-related periarteritis manifesting as an abdominal aortic aneurysm and a tumorous nodule of the coronary artery. This case report suggested that IgG4-related disease can occur in the vascular system and manifest as an aneurysm or a periarterial mass lesion.

Publication types

  • Case Reports

MeSH terms

  • Aorta, Abdominal / immunology
  • Aorta, Abdominal / pathology*
  • Aorta, Abdominal / surgery
  • Aortic Aneurysm, Abdominal / immunology
  • Aortic Aneurysm, Abdominal / pathology*
  • Aortic Aneurysm, Abdominal / surgery
  • Arteritis / immunology
  • Arteritis / pathology*
  • Arteritis / surgery
  • Atherosclerosis / immunology
  • Atherosclerosis / pathology
  • Coronary Vessels / immunology
  • Coronary Vessels / pathology*
  • Coronary Vessels / surgery
  • Female
  • Humans
  • Immunoglobulin G / blood*
  • Middle Aged

Substances

  • Immunoglobulin G