Skip Navigation LinksHome > July 2014 - Volume 21 - Issue 3 > IgG4-related Pleural Disease Presenting as a Massive Bilater...
Journal of Bronchology & Interventional Pulmonology:
doi: 10.1097/LBR.0000000000000082
Case Reports

IgG4-related Pleural Disease Presenting as a Massive Bilateral Effusion

Ishida, Atsuko MD*; Furuya, Naoki MD*; Nishisaka, Takashi MD; Mineshita, Masamichi MD*; Miyazawa, Teruomi MD, PhD*

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A 74-year-old woman with massive bilateral pleural effusion, which was exudative in nature, and with mononuclear cell predominance underwent a pleuroscopy. Parietal pleura were thickened and partly reddish in color. Biopsy specimens taken from the parietal pleura revealed lymphoplasmacytic inflammation with fibrosis. As her performance status rapidly worsened with thoracentesis, we performed bilateral pleurodesis using talc. Pathologic evaluation of the pleural biopsy specimen with immunohistochemical staining revealed 91 IgG4-positive plasma cells per high-power field and an IgG4/IgG ratio of 91%. Thus, the diagnosis of pleuritis from IgG4-related disease was established. Our case suggests that IgG4-related disease is one of the causes of pleural effusion, and it should be included in the differential diagnosis of unexplained pleuritis.

© 2014 by Lippincott Williams & Wilkins.


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