Lymphadenopathy associated with IgG4-related disease: Diagnosis & differential diagnosis.

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.

Wick MR ，O'Malley DP 《SEMINARS IN DIAGNOSTIC PATHOLOGY》

IgG4-related lymphadenopathy.

Cheuk W ，Bledsoe JR 《SEMINARS IN DIAGNOSTIC PATHOLOGY》

Lymphadenopathy of IgG4-related disease: an underdiagnosed and overdiagnosed entity.

Cheuk W ，Chan JK 《SEMINARS IN DIAGNOSTIC PATHOLOGY》

[Pathological significance of plasma cell infiltration in diagnosing lymph node diseases].

Hu H ，Jiang YJ ，Xu L ，Yin LJ ，Liu XF ，Yin SY ，Xu JJ ，He MX ... -  《-》

Immunoglobulin G4-Related Lymphadenopathy.

Immunoglobulin G4-related lymphadenopathy (IgG4-RLAD) occurs in the setting of extranodal IgG4-related disease (IgG4-RD), an immune-mediated process described in many organ systems characterized by lymphoplasmacytic infiltrates with abundant IgG4-positive plasma cells and fibrosis. Although the morphologic features in the lymph node sometimes resemble those seen at the extranodal sites, 5 microscopic patterns have been described, most of which resemble reactive lymphoid hyperplasia. This morphologic variability leads to unique diagnostic challenges and a broad differential diagnosis. As IgG4-RD may be exquisitely responsive to steroids or other immunotherapy, histologic recognition and inclusion of IgG4-RLAD in the differential diagnosis is vital.

Bookhout CE ，Rollins-Raval MA 《-》