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| 1.
論文 |
論文
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Takato, Hazuki ; Yasui, Masahide ; Ichikawa, Yukari ; Fujimura, Masaki ; Nakao, Shinji ; Zen, Yoh ; Minato, Hiroshi
概要:
金沢大学医薬保健研究域医学系<br />Recently, great attention has been drawn to IgG4-related diseases such as autoimmune pancreatitis (A
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IP) sclerosing sialadenitis, retroperitoneum fibrosis, sclerosing cholangitis. IgG4-related diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation with numerous IgG4-positive plasma cells, and steroid sensitivity irrespective of their organs of origin. In this report, we describe a case of nonspecific interstitial pneumonia, in which possible involvement of IgG4 was suggested. The patient was 59-year-old man, who was found to have bilateral interstitial pneumonia. Laboratory tests revealed that he had antinuclear antibody and a high serum IgG4 concentration. Pathological examination of the video-assisted thoracic surgery biopsy taken from the right lower lobe showed interstitial thickening associated with lymphoplasmacytic infiltration containing many IgG4-positive plasma cells. He was effectively treated by corticosteroid. The present case had many clinical and clinicopathologic similarities to systemic IgG4-related autoimmune disease. There have been no descriptions on isolated interstitial pneumonia with IgG4-positive plasma cell infiltration. This case suggested that IgG4-related disorders could also occur in the lung, and interstitial pneumonia may be a pulmonary manifestation of systemic IgG4-related autoimmune disease © 2008 The Japanese Society of Internal Medicine.
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| 2.
論文 |
論文
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Kimura, Yasushi ; Harada, Kenichi ; Nakanuma, Yasuni
概要:
Immunoglobulin G4-related sclerosing cholangitis is histologically characterized by the infiltration of immunoglobulin G
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4-positive plasma cells and sclerosing change. Moreover, several cases of carcinoma accompanied by immunoglobulin G4-positive cells in tissue and increased serum immunoglobulin G4 levels have been reported, but the association between cancer-associated immunity and an immunoglobulin G4 reaction is still unclear. In this study, we examined the infiltration of immunoglobulin G4-positive cells in extrahepatic cholangiocarcinoma and the pathologic significance of the immunoglobulin G4 reaction found in cancer tissues in terms of the evasion of immune surveillance by regulatory T cells. Immunohistochemistry for immunoglobulin G4, forkhead box P3, CD4, and CD8 was performed using 68 surgical specimens from patients with extrahepatic cholangiocarcinoma, and positive cells were investigated, particularly within and around cancerous tissues. Consequently, although immunoglobulin G4+ cells were few (average, <10 cells/high-power field) in most cases, 10 or more and 50 or more cells were found in 37% and 6% of cases, respectively. Immunoglobulin G4+ cells were predominantly found in the invasive front of carcinoma tissue. In the cases with 10 or more immunoglobulin G4+ cells, forkhead box P3+ regulatory T cells were also distinguishable, and a positive correlation was found between the forkhead box P3+/CD4+ ratio and immunoglobulin G4+ cell count, but few CD8+ cells invaded cancer cells (<10 cells). In conclusion, extrahepatic cholangiocarcinomas are often accompanied by the significant infiltration of immunoglobulin G4+ cells, and the immunoglobulin G4 reaction showed a positive and negative correlation with forkhead box P3+ and CD8+ cells, respectively, suggesting the evasion of immune surveillance associated with CD8+ cytotoxic T cells via the regulatory function of forkhead box P3+ regulatory T cells. © 2012 Elsevier Inc. All rights reserved.
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| 3.
図書 |
図書
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Harada, Kenichi ; Ubara, Yoshifumi
概要:
In the literature on IgG4-related urinary tract diseases, reports of cases with involvement of the renal pelvis and uret
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ers are increasing. IgG4-related renal pelvic and ureteral lesions accompany extra-renal organ involvement, including IgG4-related type 1 autoimmune pancreatitis, sialadenitis, and orbital disease, and are characterized by the common pathological features of IgG4-related disease (IgG4-RD), including substantial numbers of IgG4-positive plasma cells, storiform fibrosis, and stenosis in the affected organs. Similar to other mucosal organs affected in IgG4-RD, these inflammatory findings are observed within the fibroadipose tissue in the renal hilum and around the ureters. The urothelial epithelium covering the renal pelvis and ureter is preserved. Nodular lesions such as pseudotumors can also form and it is important to differentiate these from malignant tumors. At present, comprehensive diagnostic criteria that include pathological parameters have been proposed for IgG4-RD; however, obtaining diagnostic findings in small biopsy specimens is often challenging. Therefore, the diagnosis can only be rendered following careful consideration of the patient’s clinical, serologic, radiologic, and pathologic features, including the possibility of involvement in other organs. © Springer Japan 2016.<br />[Book Chapter]
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