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Abstract
Immunoglobulin G4-related sclerosing disease (IgG4-SD), also referred to as IgG4-related disease, is a newly described disease characterized by an infiltration of IgG4+ plasma cells in the early stages of the affection of an organ. Well documented in the pancreas and then detected in other organs, only few cases of thyroid affection have been reported. In addition, no case of IgG4-SD of the thyroid associated with high serum IgG4 levels has ever been described. We report here the first case.
Highlights
Fibrosis in the thyroid gland may be due to lymphoma, anaplastic carcinoma, sarcoma, multifocal sclerosing thyroiditis with lymphocyte infiltration, the sclerosing form of de Quervain’s thyroiditis, or Riedel’s disease
No case of Immunoglobulin G4-related sclerosing disease (IgG4-SD) of the thyroid associated with high serum immunoglobulins G of the G4 subclass (IgG4) levels has ever been described
The histology of the disease in the thyroid gland has been described by some authors, no case of IgG4-SD of the thyroid associated with high serum IgG4 levels has ever been
Summary
Fibrosis in the thyroid gland may be due to lymphoma, anaplastic carcinoma, sarcoma, multifocal sclerosing thyroiditis with lymphocyte infiltration, the sclerosing form of de Quervain’s thyroiditis, or Riedel’s disease. IgG4related sclerosing disease (IgG4-SD) is a newly described fibroinflammatory disease known since 2001 It is characterized by tumors composed of dense, organized lymphoplasmacytic infiltrates rich in IgG4+. These lesions can progress to cause fibrosis and may be associated with an increase in serum IgG4 levels. This disease has been reported to affect many organs, including the bile ducts, salivary glands, kidneys, and lungs, as well as the pancreas, the pericardium, the periorbital tissue, the prostate, the pituitary gland, and the thyroid (Hamano, 2001). The cytology revealed an invasion of the thyroid by fibroinflammatory tissue composed of a polymorphic cell population of B cells, T cells, macrophages, plasma cells, neutrophils, and eosinophils (Figure 1).
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