演題詳細

ポスター / Poster

ポスター 21 (Poster 21) :LPD/免疫不全・高齢者

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
岡 芳弘 (Yoshihiro Oka):1
1:大阪大学大学院医学系研究科 呼吸器・免疫アレルギー内科学
 
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IgG4-related lymphadenopathy associated with neuropathy after radiotherapy for follicular lymphoma

演題番号 : PS-1-153

武田 航 (Wataru Takeda):1、桐原 健彦 (Takehiko Kirihara):1、栗原 太郎 (Taro Kurihara):1、佐藤 慶二郎 (Keijiro Sato):1、藤川 祐子 (Yuko Fujikawa):1、清水 郁夫 (Ikuo Shimizu):1、植木 俊充 (Toshimitsu Ueki):1、廣島 由紀 (Yuki Hiroshima):1、住 昌彦 (Masahiko Sumi):1、上野 真由美 (Mayumi Ueno):1、市川 直明 (Naoaki Ichikawa):1、小林 光 (Hikaru Kobayashi):1、小島 勝 (Masaru Kojima):2

1:Department of Hematology,Nagano Red Cross Hospital,Japan.、2:Dokkyo Medical Univercity,Anatomic and Diagnostic Pathology,Japan.

 

Introduction: IgG4-related diseases (IgG4-RDs) are novel clinical disease entities characterized by IgG4-positive plasma cell infiltration into organs. Here we report on a patient with IgG4-related lymphadenopathy and neuropathy after radiotherapy for follicular lymphoma. Case: The patient was a 56-year-old Japanese man diagnosed with follicular lymphoma (Stage I) and treated with radiotherapy to the bilateral neck at 46 years of age and remained in CR. Ten years after lymphoma therapy, he suffered from dysesthesia of the feet and had difficulty walking. A nerve conduction study revealed axonal neuropathy. Chest X-ray revealed mediastinal lymph node swelling and a CT scan revealed lymphadenopathy in various regions, including the bilateral neck and supraclavicular, mediastinal, axillary, inguinal, and abdominal cavities. PET-CT showed abnormal accumulation in the same regions. Based on these findings, relapse of follicular lymphoma was suspected. Findings suggestive of lymphoma were not obtained by supraclavicular lymph node biopsy. Serum IgG levels were elevated (2000-3000 mg/dL), as were IgG4 levels (1130 mg/dL). Mediastinal lymph node biopsy revealed infiltration of IgG4-positive plasma cells, which led to a diagnosis of IgG4-RDs. Prednisolone improved the dysesthesia and reduced lymph node swelling. Discussion: In the present case, neuropathy was related to IgG4-RDs, for which only a few reports exist. There are also no reports of IgG4-RDs occurring after follicular lymphoma. Further studies will be needed to determine the relationship between lymphoma and IgG4-RDs.

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