Sonographic Evaluation of the Treatment Response in Patients With Immunoglobulin G4–Related Disease of the Submandibular Glands

Asai, Satoshi; Sato, Shinji; Okami, Kenji; Takanashi, Noboru; Umezawa, Kazuo; Damdinsuren, Anar; Matsushita, Hiromichi; Nakamura, Naoya; Suzuki, Yasuo; Miyachi, Hayato

doi:10.7863/ultra.34.5.783

Cited by 4 publications

(3 citation statements)

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“…69 Gross morphologic changes are often organ specific: a tumefactive mass is common in pancreatic involvement, with diffuse enlargement of the entire organ; 58 in organs such as salivary glands, discrete areas of disease are seen on a background of unaffected tissue even though no discernible difference in tissue constituency can be observed. 70 Lymphoplasmacytic infiltrate laden with IgG4positive plasma cells on a background of storiform fibrosis and obliterative phlebitis describes the distinctive histopathology that unifies the diagnosis of IgG4-related disease. 71 Thus, a comprehensive and meaningful assessment of tissue in this setting will require IgG4 immunostaining.…”

Section: Histologic Assessmentmentioning

confidence: 99%

An overview of the diagnosis and management of immunoglobulin G4–related disease

Haldar

Cockwell

Richter

et al. 2016

CMAJ

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What pathophysiologic mechanisms are involved in IgG4-related disease? The pathophysiology of IgG4-related disease is uncertain. Both genetic predisposition and environmental triggers may prompt aberrant immune pathways to perpetuate the disease. 15 An overview of current understanding of the disease is shown in Figure 1. 15-23 The pathology seems to be primarily affected by B cells. Patients with IgG4-related disease carry dominantly expanded clones of tissue B cells that produce immunoglobulins with greater antigen affinity and, preferentially, make more IgG4. However, the pathogenic role of IgG4 remains a contentious issue in view of its immune-modulating properties. 15,24 Expansion of regulatory T cells is observed, 22 which may contribute to fibrosis. Furthermore, a modified type 2 T-helper (Th2) cellular response 25 augments B-cell changes. 26,27 Maturation of B cells may also be directly stimulated by microbial components. 28 An overview of the diagnosis and management of immunoglobulin G4-related disease

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Section: Histologic Assessmentmentioning

confidence: 99%

An overview of the diagnosis and management of immunoglobulin G4–related disease

Haldar

Cockwell

Richter

et al. 2016

CMAJ

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“…The diagnostic process for identifying syphilitic initial induration when oral lesions are encountered in daily clinical practice is critical, due to its increasing incidence and the multifarious routes of transmission by sexual intercourse, including oral transmission. Ultrasound examinations are non-invasive, easy, and prompt [ 5 – 9 ]. Furthermore, pressure testing using a probe to investigate the elasticity of a lesion is useful for differentiating tumors of superficial organs [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Primary infection of an oral lesion includes chancre, painless tonsillar enlargement, and painless lymphadenopathy [ 4 ]. Ultrasonography is known to be useful in diagnosing tumorous lesions of the head and neck, such as the submandibular glands and lymph nodes [ 5 – 9 ]. Some cases of primary syphilis with initial induration or chancre have been reported [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report

et al. 2020

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Background Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. Recently, its incidence has been increasing worldwide. We encountered a young woman who presented with induration mimicking squamous cell carcinoma in the lower lip, without major medical conditions. Case presentation A 25-year-old Japanese woman presented with a 1-month history of a painless induration in her lower lip. Because squamous cell carcinoma was suspected, a preoperation work up was performed, including laboratory tests, an ultrasonographic examination, and a biopsy. The ultrasonography findings showed an oval-shaped 17 × 11 × 12 mm tumor-like lesion with heterogeneous internal echo and an indistinct border. A pressure test and color Doppler sonography revealed that the lesion was soft with a very abundant blood flow. These findings suggested the possibility of underlying inflammatory causes rather than a neoplastic tumor. Serology tests for syphilis, including the anti-Treponema pallidum antibody and reactive rapid plasma reagin tests, were positive. The biopsy revealed no malignancy. Finally, she was diagnosed as having primary syphilis and treated with amoxicillin for 28 days. The rapid plasma reagin value gradually decreased and the initial induration in her lower lip disappeared. Conclusion This case highlights the need for prompt examinations for possible underlying infective causes, such as syphilis, when seeing a painless induration with ulcer in the lip. Ultrasonography was helpful in the differential diagnosis of a tumor-like lesion and should be included in addition to syphilis serology tests, such as anti-Treponema pallidum antibody and rapid plasma reagin tests.

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Sonographic findings of immunoglobulin G₄-related sialadenitis and differences from Sjögren’s syndrome

Liu

Wang

Ren

et al. 2021

Scandinavian Journal of Rheumatology

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Sonographic Evaluation of the Treatment Response in Patients With Immunoglobulin G4–Related Disease of the Submandibular Glands

Abstract: Sonography is considered useful for evaluating the response to glucocorticoid therapy in patients with IgG4-related disease of the submandibular glands.

Cited by 4 publications

References 16 publications

An overview of the diagnosis and management of immunoglobulin G4–related disease

An overview of the diagnosis and management of immunoglobulin G4–related disease

Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report

Sonographic findings of immunoglobulin G₄-related sialadenitis and differences from Sjögren’s syndrome

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Sonographic Evaluation of the Treatment Response in Patients With Immunoglobulin G4–Related Disease of the Submandibular Glands

Abstract: Sonography is considered useful for evaluating the response to glucocorticoid therapy in patients with IgG4-related disease of the submandibular glands.

Cited by 4 publications

References 16 publications

An overview of the diagnosis and management of immunoglobulin G4–related disease

An overview of the diagnosis and management of immunoglobulin G4–related disease

Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report

Sonographic findings of immunoglobulin G4-related sialadenitis and differences from Sjögren’s syndrome

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Sonographic findings of immunoglobulin G₄-related sialadenitis and differences from Sjögren’s syndrome