ObjectiveTo summarize the clinical characteristic of IgG4 related lung disease. MethodsThe clinical manifestation,laboratory examination,imaging,diagnosis and treatment data of 2 patients with IgG4 related lung disease admitted in the PLA General Hospital from January 2000 to January 2014 were collected and analyzed retrospectively.Related literatures were also reviewed. ResultsThe serum IgG level of IgG4 related lung disease might be normal and the levels of IgG1,2,3 and 4 might increase.Some autoantibodies were positive.IgG4 related lung disease could be easily misdiagnosed as Sjogren's syndrome associated with interstitial pneumonia when the lacrimal gland and salivary gland were involved,and the chest CT occasionally showed multiple vesicles.The immunochemical staining of lung tissues revealed the increase of IgG4/IgG and the number of IgG4 positive lymphatic plasma cells >10/HP.The combination of clinical manifestation,laboratory examination,imaging and pathology results was more conducive for the diagnosis of IgG4 related lung disease.After the treatment of glucocorticoid,the clinical symptoms were relieved and the serum IgG4 level obviously decreased. ConclusionIgG4 related lung disease is rare in clinic,which can involve the lung alone or multiple organs.The increase of IgG4/IgG indicated by the immunochemical staining of lung tissues is the gold standard for diagnosis.Glucocorticoid has good treatment effect in IgG4 related lung disease.
ObjectiveTo explore the clinical characteristics, diagnosis and treatment methods of pulmonary mucosa-associated lymphoid tissue lymphoma. MethodsClinical manifestations, laboratory examinations, imaging, diagnosis and treatment data of 23 patients with pulmonary mucosa-associated lymphoma were collected and related literatures were reviewed. ResultsAmong the 23 patients, 14 were males and 9 females, aged 22 to 71 years old, with a median age of 58 years old. Seven patients were found in physical examination, 15 patients showed respiratory symptoms, and 1 patient was diagnosed with flatness on percussion. According to the pulmonary CT scan, 10 patients showed large consolidations, 9 patients showed mass shadows with air bronchograms, 10 patients showed nodular shadows, 1 patient showed small reticular shadows, and 1 patient was observed with subcarinal mass in the mediastinum; 1 patient was observed with a decreased lung volume. Immunohistochemistry examination showed CD20 (+), cyclind-1 (-), and Ki-67 index was from 5% to 25%. Ten patients were treated with chemotherapy, 9 patients were treated with surgery, 1 patient was treated with radiotherapy and surgery, and 3 patients were untreated. ConclusionsPulmonary mucosa-associated lymphoid tissue lymphoma is a low-moderate malignant tumor, with insidious clinical onset, and patients usually go for treatment due to physical examination and mild respiratory symptoms. Imaging findings are mainly pulmonary consolidation and mass shadows associated with air bronchograms. Confirmed diagnosis is primarily made by pathology and immunohistochemistry. Currently, there is still some controversy over a variety of treatment options, including observation, surgery, surgery combined with chemotherapy, chemotherapy alone, and radiotherapy. The patients' prognosis and survival time are both excellent.