Lymphadenopathy associated with IgG4-related disease: Diagnosis & differential diagnosis |
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| Institution: | 1. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;2. Department of Pathology, National University Hospital, Singapore;3. Department of Pathology and Laboratory Medicine, University of Indiana School of Medicine, IN, USA;4. Clarient Laboratories, Alisio Viejo, CA, USA;5. Department of Pathology, Cornell University School of Medicine, New York, NY, USA;1. Department of Pathology, Ghent University and Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium;2. CRIG, Cancer Research Institute Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium |
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| Abstract: | IgG4-related sclerosing disease, which now encompasses diverse organ-related disorders with various prior eponymic designations, may also present with solitary or multifocal lymph node enlargement. This review considers the histopathologic features of IgG4 lymphadenopathy (IgG4LAD), which has been subdivided by Cheuk & Chan into 5 microscopic subtypes. Those include variants that are typified by multicentric Castleman disease (MCD)-like changes, follicular hyperplasia, interfollicular lymphoplasmacytic proliferation, progressive transformation of germinal centers, and formation of inflammatory pseudotumor (IPT)-like lesions. All of them demonstrate an excess of IgG4-immunoreactive plasma cells in the inflammatory cell population. Differential diagnostic considerations for IgG4LAD include true MCD, true IPT, luetic lymphadenitis, Rosai-Dorfman disease, and inflammatory myofibroblastic tumor, among others. An interpretative distinction between malignant lymphoma and IgG4LAD is also crucial. |
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| Keywords: | IgG4-related sclerosing disease Benign lymphadenopathies Autoimmune disorders Castleman disease Progressive transformation of germinal centers Inflammatory pseudotumor |
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