Immunoglobulin G4-related disease of the paranasal sinuses

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is becoming increasingly documented. It was first described in relation to autoimmune pancreatitis. Features of the disease include tissue infiltration by IgG4 plasma cells with associated fibrosis and the growth of pseudotumours. A 71-year-old woman presented with increasing right cheek swelling and mild proptosis. Ten years earlier, she had a similar presentation and was diagnosed with an inflammatory pseudotumour. Examination revealed a lesion in the right nasal cavity. CT and MRI confirmed a mass within the right maxillary antrum extending into the nasal cavity. Endoscopic biopsies showed florid plasma cell infiltrate with marked increase in IgG+ plasma cells. Immunostaining expressed IgG4 (70%). She was started on a course of prednisolone and her symptoms resolved. IgG4-RD is becoming an emerging disease entity. Its involvement in the paranasal sinuses can mimic nasal tumours. Major surgical resection should be avoided as patients can often be treated medically.

Sinonasal immunoglobin G4—related disease: case report and review

“…Ultimately, 20 references meeting the selection criteria were included. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The epidemiology, presentation, imaging characteristics, locations of involvement, IgG4 serum and histopathologic levels, treatments rendered, and follow-up of all 31 cases (when available) were extracted and summarized.…”

Sinonasal IgG4-RD: Case Report and Systematic Review

“…Ultimately, 20 references meeting the selection criteria were included. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Epidemiology, presentations, imaging characteristics, locations of involvement, IgG4 serum and histopathologic levels, treatments rendered, and follow-up of all 31 cases (when available) were extracted and summarized.…”

Immunoglobulin G4-Related Disease Presenting as Temporal Bone Lesion with Facial Nerve Palsy

“…Its key characteristic is IgG4-positive plasma cell tissue infiltration. In the head and neck region, IgG4-RD can manifest in different ways, like otologic pathology similar to chronic mastoiditis and cholesteatoma [4-8] or as a paranasal sinus-affecting entity [9, 10]. Our case presented clinically with otologic symptoms and facial nerve weakness.…”