Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease
A 44‐year‐old man was referred to our hospital after an anterior mediastinal tumor was noted on computed tomography during follow‐up observation after left testicular seminoma resection. Chest computed tomography revealed an enhanced mass measuring 33 x 16 x 15 mm at the anterior mediastinum. Chest...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.12914 |
| _version_ | 1819080987193114624 |
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| author | Risa Oda Katsuhiro Okuda Takayuki Murase Takuya Watanabe Tadashi Sakane Tsutomu Tatematsu Keisuke Yokota Hiroshi Haneda Ryoichi Nakanishi |
| author_facet | Risa Oda Katsuhiro Okuda Takayuki Murase Takuya Watanabe Tadashi Sakane Tsutomu Tatematsu Keisuke Yokota Hiroshi Haneda Ryoichi Nakanishi |
| author_sort | Risa Oda |
| collection | DOAJ |
| description | A 44‐year‐old man was referred to our hospital after an anterior mediastinal tumor was noted on computed tomography during follow‐up observation after left testicular seminoma resection. Chest computed tomography revealed an enhanced mass measuring 33 x 16 x 15 mm at the anterior mediastinum. Chest magnetic resonance imaging revealed high signal intensity on T2‐weighted imaging, and F18 fluorodeoxyglucose‐positron emission tomography showed a maximum standardized uptake of 12.45. Laboratory tests revealed no elevated tumor markers, except for mildly elevated interleukin‐2. Based on these results, complete resection was performed under suspicion of a malignant tumor, mediastinal metastasis of seminoma, or malignant lymphoma. An extended thymectomy with partial merger pericardial resection was performed using a subxiphoid approach. Small nodules and multiple thymic cysts were observed the thymus in addition to the main mass. Microscopic examination of the tumor revealed fibrosis, lymphocyte infiltration with lymphoid follicular hyperplasia, and hyperplasia of the thymus. Numerous immunoglobulin G4 (IgG4)‐positive plasma cells were found on immunohistochemical staining. The ratio of IgG4 to total IgG was approximately 60%. We ultimately diagnosed the patient with a thymic inflammatory pseudotumor with multilocular cyst caused by IgG4‐related disease. |
| first_indexed | 2024-12-21T19:53:36Z |
| format | Article |
| id | doaj.art-7036b14b0ba249e3b5ac0387857ae242 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-21T19:53:36Z |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-7036b14b0ba249e3b5ac0387857ae2422022-12-21T18:52:09ZengWileyThoracic Cancer1759-77061759-77142019-01-0110111611910.1111/1759-7714.12914Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related diseaseRisa Oda0Katsuhiro Okuda1Takayuki Murase2Takuya Watanabe3Tadashi Sakane4Tsutomu Tatematsu5Keisuke Yokota6Hiroshi Haneda7Ryoichi Nakanishi8Department of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Pathology and Molecular Diagnostics Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Oncology, Immunology and Surgery Nagoya City University Graduate School of Medical Sciences Nagoya JapanA 44‐year‐old man was referred to our hospital after an anterior mediastinal tumor was noted on computed tomography during follow‐up observation after left testicular seminoma resection. Chest computed tomography revealed an enhanced mass measuring 33 x 16 x 15 mm at the anterior mediastinum. Chest magnetic resonance imaging revealed high signal intensity on T2‐weighted imaging, and F18 fluorodeoxyglucose‐positron emission tomography showed a maximum standardized uptake of 12.45. Laboratory tests revealed no elevated tumor markers, except for mildly elevated interleukin‐2. Based on these results, complete resection was performed under suspicion of a malignant tumor, mediastinal metastasis of seminoma, or malignant lymphoma. An extended thymectomy with partial merger pericardial resection was performed using a subxiphoid approach. Small nodules and multiple thymic cysts were observed the thymus in addition to the main mass. Microscopic examination of the tumor revealed fibrosis, lymphocyte infiltration with lymphoid follicular hyperplasia, and hyperplasia of the thymus. Numerous immunoglobulin G4 (IgG4)‐positive plasma cells were found on immunohistochemical staining. The ratio of IgG4 to total IgG was approximately 60%. We ultimately diagnosed the patient with a thymic inflammatory pseudotumor with multilocular cyst caused by IgG4‐related disease.https://doi.org/10.1111/1759-7714.12914Anterior mediastinal tumorimmunoglobulin G4‐related (IgG4‐ related) diseasethymus |
| spellingShingle | Risa Oda Katsuhiro Okuda Takayuki Murase Takuya Watanabe Tadashi Sakane Tsutomu Tatematsu Keisuke Yokota Hiroshi Haneda Ryoichi Nakanishi Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease Thoracic Cancer Anterior mediastinal tumor immunoglobulin G4‐related (IgG4‐ related) disease thymus |
| title | Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease |
| title_full | Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease |
| title_fullStr | Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease |
| title_full_unstemmed | Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease |
| title_short | Thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin G4‐related disease |
| title_sort | thymic inflammatory pseudotumor with multilocular thymic cyst caused by immunoglobulin g4 related disease |
| topic | Anterior mediastinal tumor immunoglobulin G4‐related (IgG4‐ related) disease thymus |
| url | https://doi.org/10.1111/1759-7714.12914 |
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