Development of IgG4-related disease 10 years after chemotherapy for diffuse large B cell lymphoma and longstanding bronchial asthma

Int J Hematol. 2013 Jul;98(1):122-8. doi: 10.1007/s12185-013-1359-z. Epub 2013 May 12.

Abstract

Reported is a rare case IgG4-related disease that developed 10 years after combination chemotherapy for non-Hodgkin lymphoma. A 59-year-old Japanese man with longstanding bronchial asthma was referred to our hospital for bilateral hilar lymph node enlargement. The initial diagnosis was diffuse large B cell lymphoma (DLBCL) by supraclavicular lymph node biopsy. Serum IgG was high (4550 mg/dL) at diagnosis. The patient achieved complete response following six cycles of combination chemotherapy. Ten years later, bilateral submaxillary gland swelling was observed. Serum IgG and IgG4 were 2909 and 1470 mg/dL, respectively. The patient was diagnosed with IgG4-related disease by submandibular lymph node biopsy. Due to the difficulty in distinguishing IgG4-related disease from DLBCL through imaging findings alone, pathological confirmation of such lesions by biopsy is mandatory before proceeding to treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asthma / complications*
  • Asthma / drug therapy
  • Diagnosis, Differential
  • Humans
  • Hypergammaglobulinemia / blood
  • Hypergammaglobulinemia / complications
  • Hypergammaglobulinemia / diagnosis*
  • Hypergammaglobulinemia / immunology
  • Immunoglobulin G / analysis*
  • Immunoglobulin G / biosynthesis
  • Lymphoma, Large B-Cell, Diffuse / complications*
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Male
  • Middle Aged

Substances

  • Immunoglobulin G