IgG4-related Disease in the Stomach which Was Confused with Gastrointestinal Stromal Tumor (GIST): Two Case Reports and Review of the Literature

서호석; 정영주; 박조현; 송교영; 정은선

doi:https://doi.org/10.5230/jgc.2018.18.e8

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자료유형: 학술저널

저자정보: 서호석 (가톨릭대학교) 정영주 (대구가톨릭대학교) 박조현 (가톨릭대학교) 송교영 (가톨릭대학교) 정은선 (가톨릭대학교)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제18권 제1호

발행연도: 2018.3

수록면: 99 - 107 (9page)

DOI: https://doi.org/10.5230/jgc.2018.18.e8

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Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40?50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration. She underwent a completion total gastrectomy with splenectomy for the gastric SET and ITP. The pathology showed storiform fibrosis, and IgG4 was positive in immunohistochemistry (IHC) stain. IgG4-RD is known as a medical disease that could be treated with oral steroids. The difficulty in preoperative diagnosis of the disease occasionally causes unnecessary gastric resection. Thus, preoperative diagnostic methods for IgG4-RD such as deep biopsy with IHC stain or magnetic resonance imaging are needed.

#Immunoglobulin G #Gastrointestinal stromal tumors

참고문헌 (35)

참고문헌 신청

Stone JH / 2012 / IgG4-related disease / N Engl J Med 366:539~551

Kamisawa T / 2003 / A new clinicopathological entity of IgG4-related autoimmune disease / J Gastroenterol 38:982~984

Inoue D / 2009 / Immunoglobulin G4-related lung disease: CT findings with pathologic correlations / Radiology 251:260~270

Hamano H / 2001 / High serum IgG4 concentrations in patients with sclerosing pancreatitis / N Engl J Med 344:732~738

Zen Y / 2016 / The pathology of IgG4-related disease in the bile duct and pancreas / Semin Liver Dis 36:242~256

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