Helana Jeries, Yolanda Braun-Moscovici, Alexandra Balbir-Gurman
{"title":"IgG4 相关乳腺疾病:文献综述","authors":"Helana Jeries, Yolanda Braun-Moscovici, Alexandra Balbir-Gurman","doi":"10.5041/RMMJ.10532","DOIUrl":null,"url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is a rare illness with inflammatory and fibrotic changes in affected organs such as pancreas, thyroid, salivary or lacrimal glands, and retroperitoneal space; rarely other organs may be involved. IgG4-related breast disease (IgG4-BD) is very rare and generally presents as a lump or mastitis. IgG4-BD as a presenting feature of IgG4-RD is extremely rare. Hence, this paper reviews the known (n=48) IgG-BD cases reported in the literature to date. The majority of cases were diagnosed on routine mammography or during assessment for other clinically significant features. The absence of a lump border, and especially the absence of calcifications on ultrasonography, mammography, or computed tomography, is typical for IgG4-BD. Characteristic IgG4-BD pathological findings were dense lymphoplasmacytic infiltration with stromal fibrosis, and more than 10% IgG4<sup>+</sup> plasma cells/high-power field (HPF); the mean percentage of IgG4<sup>+</sup>/IgG<sup>+</sup> plasma cells was 54.2%, and only one-third of the patients had all \"classical\" signs of IgG4-BD including storiform fibrosis and obliterative phlebitis. Most of the cases had a benign course and responded to surgical excision with or without steroid therapy.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"15 4","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524419/pdf/","citationCount":"0","resultStr":"{\"title\":\"IgG4-related Breast Disease: Review of the Literature.\",\"authors\":\"Helana Jeries, Yolanda Braun-Moscovici, Alexandra Balbir-Gurman\",\"doi\":\"10.5041/RMMJ.10532\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>IgG4-related disease (IgG4-RD) is a rare illness with inflammatory and fibrotic changes in affected organs such as pancreas, thyroid, salivary or lacrimal glands, and retroperitoneal space; rarely other organs may be involved. IgG4-related breast disease (IgG4-BD) is very rare and generally presents as a lump or mastitis. IgG4-BD as a presenting feature of IgG4-RD is extremely rare. Hence, this paper reviews the known (n=48) IgG-BD cases reported in the literature to date. The majority of cases were diagnosed on routine mammography or during assessment for other clinically significant features. The absence of a lump border, and especially the absence of calcifications on ultrasonography, mammography, or computed tomography, is typical for IgG4-BD. Characteristic IgG4-BD pathological findings were dense lymphoplasmacytic infiltration with stromal fibrosis, and more than 10% IgG4<sup>+</sup> plasma cells/high-power field (HPF); the mean percentage of IgG4<sup>+</sup>/IgG<sup>+</sup> plasma cells was 54.2%, and only one-third of the patients had all \\\"classical\\\" signs of IgG4-BD including storiform fibrosis and obliterative phlebitis. Most of the cases had a benign course and responded to surgical excision with or without steroid therapy.</p>\",\"PeriodicalId\":46408,\"journal\":{\"name\":\"Rambam Maimonides Medical Journal\",\"volume\":\"15 4\",\"pages\":\"\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524419/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Rambam Maimonides Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5041/RMMJ.10532\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rambam Maimonides Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5041/RMMJ.10532","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
IgG4 相关疾病(IgG4-RD)是一种罕见的疾病,受累器官(如胰腺、甲状腺、唾液腺或泪腺以及腹膜后间隙)会出现炎症和纤维化病变;很少有其他器官会受累。IgG4相关性乳腺疾病(IgG4-BD)非常罕见,一般表现为肿块或乳腺炎。IgG4-BD作为IgG4-RD的表现特征极为罕见。因此,本文回顾了迄今为止文献报道的已知 IgG-BD 病例(48 例)。大多数病例是在常规乳腺 X 射线检查或评估其他临床重要特征时确诊的。IgG4-BD的典型特征是没有肿块边界,尤其是在超声波、乳腺X线摄影或计算机断层扫描中没有钙化。IgG4-BD的特征性病理结果是致密的淋巴浆细胞浸润伴基质纤维化,IgG4+浆细胞/高倍视野(HPF)超过10%;IgG4+/IgG+浆细胞的平均比例为54.2%,只有三分之一的患者具有IgG4-BD的所有 "经典 "体征,包括基质纤维化和闭塞性静脉炎。大多数病例的病程为良性,并对手术切除加或不加类固醇治疗有反应。
IgG4-related Breast Disease: Review of the Literature.
IgG4-related disease (IgG4-RD) is a rare illness with inflammatory and fibrotic changes in affected organs such as pancreas, thyroid, salivary or lacrimal glands, and retroperitoneal space; rarely other organs may be involved. IgG4-related breast disease (IgG4-BD) is very rare and generally presents as a lump or mastitis. IgG4-BD as a presenting feature of IgG4-RD is extremely rare. Hence, this paper reviews the known (n=48) IgG-BD cases reported in the literature to date. The majority of cases were diagnosed on routine mammography or during assessment for other clinically significant features. The absence of a lump border, and especially the absence of calcifications on ultrasonography, mammography, or computed tomography, is typical for IgG4-BD. Characteristic IgG4-BD pathological findings were dense lymphoplasmacytic infiltration with stromal fibrosis, and more than 10% IgG4+ plasma cells/high-power field (HPF); the mean percentage of IgG4+/IgG+ plasma cells was 54.2%, and only one-third of the patients had all "classical" signs of IgG4-BD including storiform fibrosis and obliterative phlebitis. Most of the cases had a benign course and responded to surgical excision with or without steroid therapy.