30 May 2021>: Articles
Systemic IgG4-Related Disease Masquerading as Cholangiocarcinoma: A Case Report Underscoring the Importance of Medical History
Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Benjamin P.M. Gummlich A , Philipp Ströbel B , Ali Seif Amir Hosseini B , Albrecht Neesse D , Volker Ellenrieder D , Harald Schwörer A*DOI: 10.12659/AJCR.930729
Am J Case Rep 2021; 22:e930729
Figure 3B. Retrospectively analyzed immunoglobulin (Ig) G4 preparations in chronological order: Submandibular gland (left) with lymph nodes (right) 7 years before the diagnosis of IgG4-RD. (a) Low-power magnification (HE, ×10) of the submandibular gland (left side) and enlarged cervical lymph node (right side) with (b) increased number of lymphoid follicles (HE, ×100). At higher magnification (c), the germinal centers have a monotonous appearance with loss of proliferation areas (HE, ×200) and (d) increased numbers of plasma cells and eosinophilic granulocytes (HE, ×400). Immunohistochemistry shows significantly increased numbers of IgG4-positive plasma cells (e) relative to IgG-positive forms (f) (immunoperoxidase, ×200).