IgG4相关疾病累及腮腺1例并文献复习

目的 探讨IgG₄相关疾病(IgG₄-related diseases,IgG₄-RD)累及腮腺的临床表现、诊断标准、治疗方案以及细针穿刺在疾病诊断中的应用，减少临床误诊漏诊。方法 回顾分析华北理工大学附属医院2020年11月收治的1例累及腮腺的IgG₄-RD病人的病例资料，通过分析临床特点、血清学指标、影像学表现及术后病理学特征等，并复习相关文献进行分析总结。结果该66岁男性病人以右侧腮腺无痛性肿物为主要表现，行抗感染治疗后肿物无明显变化，先后两次行细针穿刺均未明确诊断，行手术切除后病理结果确诊为累及腮腺的IgG₄-RD，结合病人术前检查及术后病理结果，考虑病变处于非活动期，暂未给予药物治疗，密切随访，至今未见复发。结论 IgG₄相关疾病为临床罕见疾病，缺乏典型的临床表现及特异的影像学特征，术前多不能明确诊断，病理学检查在疾病的诊断中具有重要意义，而细针穿刺在疾病的诊断中价值有限，需引起临床医生的重视。

IgG4-related diseases of the parotid gland: a case and review of the literature

Objective To explore the clinical manifestations, diagnostic criteria, treatment options and application of fine needle aspiration in the diagnosis of IgG4-related diseases (IgG4-RD) involving the parotid gland and to reduce clinical misdiagnosis and leakage.Methods We retrospectively analyzed the case data of a patient with IgG4-RD disease involving the parotid gland admitted to theNorth China University of Science and Technology Affiliated Hospital in November 2020 and summarized the results by analyzing clinical features, serological indexes, imaging manifestations and postoperative pathological features, and reviewing the relevant literature..Results A 66-year-old male patient presented with painless swelling in the right parotid gland, and the swelling did not change significantly after anti-infection treatment. After surgical excision, the pathological findings confirmed the diagnosis of IgG4-RD involvingthe parotid gland. In combination with the preoperative examination and postoperative pathological results, the patient was consideredto be inactive and was not given drug treatment for the time being.Conclusion IgG4 -related diseases are rare diseases with low incidence, lack of typical clinical manifestations and specific imaging features, and mostly cannot be clearly diagnosed preoperatively.Pathological examination is important in the diagnosis of the disease, while fine needle aspiration has limited value in the diagnosis ofthe disease, which needs to be considered by clinicians.