2019
DOI: 10.4103/jmu.jmu_66_18
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IgG4-Related Disease Presenting as Cervical Lymphadenopathy

Abstract: Cervical lymph node enlargement as the first and sole manifestation of IgG4-related disease (IgG4-RD) is rare and is often difficult to distinguish from lymphoma. Here, we report a case of a 63-year-old man initially presenting with bilateral posterior neck masses. Ultrasonography revealed multiple matted, ovoid, homogenous, hypoechoic, and enlarged lymph nodes below the right parotid gland. In addition, there was heterogeneous echotexture with small and indistinct hypoechoic nodules over bilateral parotid and… Show more

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Cited by 5 publications
(6 citation statements)
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“…The recommended dosage is prednisone 0.6 mg /kg/day for 2 to 4 weeks. After 3–6 months, it is gradually reduced to 5 mg/day, and then 2.5–5 mg/day for 3 years [ 37 , 40 , 43 , 44 , 48 ]. The dosage of corticosteroids can be adjusted according to the severity of the patient’s condition.…”
Section: Discussionmentioning
confidence: 99%
“…The recommended dosage is prednisone 0.6 mg /kg/day for 2 to 4 weeks. After 3–6 months, it is gradually reduced to 5 mg/day, and then 2.5–5 mg/day for 3 years [ 37 , 40 , 43 , 44 , 48 ]. The dosage of corticosteroids can be adjusted according to the severity of the patient’s condition.…”
Section: Discussionmentioning
confidence: 99%
“…Considering that non-IgG4-related lymphadenopathy or even nonspecific reactive lymphadenopathies may show a significant increase in IgG4-positive cells [13][14][15][16] and the present patient had an infection at the ipsilateral lower extremity without a sign of extranodal IgG4-related disease involvement, we had to be very careful in diagnosing IgG4related disease. The diagnostic criteria for IgG4-related disease are as follows [2,11,17]:…”
Section: Discussionmentioning
confidence: 99%
“…Considering that non-IgG4-related lymphadenopathy or even nonspecific reactive lymphadenopathies may show a significant increase in IgG4-positive cells [ 13 , 14 , 15 , 16 ] and the present patient had an infection at the ipsilateral lower extremity without a sign of extranodal IgG4-related disease involvement, we had to be very careful in diagnosing IgG4-related disease. The diagnostic criteria for IgG4-related disease are as follows [ 2 , 11 , 17 ]: (1) clinical examination showing characteristic diffuse/localized swelling or masses in one or more organs; (2) hematologic examination showing elevated serum IgG4 concentrations (over 135 mg/dL); and (3) histopathologic examination showing marked lymphoplasmacytic infiltration and storiform fibrosis, as well as organ infiltration by IgG4-positive plasma cells. If all three criteria are met, it is considered definite; if the first and third criteria are met, it is considered probable; and if the first and second criteria are met, it is considered possible.…”
Section: Discussionmentioning
confidence: 99%
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