A Case of Immunoglobulin G4-Related Sclerosing Disease of the Paranasal Sinus Mimicking Nasal Malignancy

Chung, Juyong; Lee, Jae Hoon

doi:2017.24.1.60

J Rhinol > Volume 24(1); 2017

Case Report

Journal of Rhinology 2017;24(1):60-64.
Published online May 31, 2017.
DOI: https://doi.org/10.18787/jr.2017.24.1.60

A Case of Immunoglobulin G4-Related Sclerosing Disease of the Paranasal Sinus Mimicking Nasal Malignancy

Juyong Chung, Jae Hoon Lee

Department of Otorhinolaryngology-Head and Neck Surgery, Wonkwang University College of Medicine, Iksan, Korea. leejaehoon64@gmail.com

비강내 악성종물로 오인된 부비동의 Immunoglobulin G4 연관 경화성 질환 1예

정주용, 이재훈

원광대학교 의과대학 이비인후과학교실

Abstract

Immunoglobulin G4 (IgG4)-related sclerosing disease (RSD) is a chronic inflammatory disorder characterized by elevated serum IgG4 levels as well as an abundant infiltration of IgG4-positive plasmacytes. Involvement of the paranasal sinus is very rare, so it is difficult to make an accurate diagnosis. Hence, various differential diagnoses, which typically include elevated serum IgG4 levels and the infiltration of IgG4-postive cells into tissues, need to be excluded, especially for malignant diseases and mimicking disorders. Systemic corticosteroids are generally effective at inducing IgG4-RSD remission. Recently, a 43-year-old woman presented with a mass originating from the ethmoid sinus, suggesting malignancy. The patient underwent biopsy of the lesion. The pathologic specimen revealed the magnitude of IgG4-positive plasma cell infiltration, which was consistent with IgG4-RSD. In addition, serum IgG4 levels were markedly increased. After glucocorticoid treatment, the serum IgG4 levels decreased and the symptoms improved. We present a rare case of IgG4-RSD with isolated involvement of the paranasal sinuses.

Key Words: Immunoglobulin G4;Sclerosing disease;Paranasal sinus