Clinicopathological analysis of salivary gland tissue from patients with IgG4-related disease

Abstract Conclusion The diagnosis of immunoglobulin G4-related disease (IgG4-RD) should be based on the morphology of tissue biopsy, and this study recommends a submandibular gland (SMG) biopsy for accurate diagnosis and to exclude malignant disease. Objective To clarify which type of biopsy specimen (SMG or labial salivary gland [LSG]) should be taken from patients with IgG4-RD. Methods This study included 33 patients with IgG4-RD (21 women; 12 men) who were subjected to both SMG and LSG biopsies at Sapporo Medical University between 2011–2015. Tissues obtained from the SMG and LSG specimens were evaluated. Results All SMG specimens satisfied the diagnostic criteria for IgG4-RD, whereas 19 (57.6%) LSG specimens satisfied the diagnostic criteria for IgG4-RD. Histological evaluation showed fibrosis in all the SMG specimens and in eight LSG specimens (24.2%). Obliterative phlebitis was seen in nine SMG specimens (27.3%), but it was absent in all the LSG specimens.

[1]  J. Stone,et al.  IgG4-related disease and the kidney , 2015, Nature Reviews Nephrology.

[2]  J. Stone,et al.  IgG4-related disease , 2015, The Lancet.

[3]  T. Himi,et al.  Evaluation of submandibular versus labial salivary gland fibrosis in IgG4-related disease , 2014, Modern rheumatology.

[4]  M. Moriyama,et al.  The diagnostic utility of biopsies from the submandibular and labial salivary glands in IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz's disease. , 2014, International journal of oral and maxillofacial surgery.

[5]  Y. Shinomura,et al.  Mechanisms and assessment of IgG4-related disease: lessons for the rheumatologist , 2014, Nature Reviews Rheumatology.

[6]  Tomohiro Watanabe,et al.  Risk of Cancer in Patients With Autoimmune Pancreatitis , 2013, The American Journal of Gastroenterology.

[7]  Vikram Deshpande,et al.  IgG4-Related Disease , 2013, International journal of rheumatology.

[8]  D. Sahani,et al.  Consensus statement on the pathology of IgG4-related disease , 2012, Modern Pathology.

[9]  Hiroyuki Yamamoto,et al.  Risk of malignancies in IgG4-related disease , 2012, Modern rheumatology.

[10]  J. Stone,et al.  IgG4-related disease. , 2012, The New England journal of medicine.

[11]  T. Himi,et al.  A novel concept of Mikulicz's disease as IgG4-related disease. , 2012, Auris, nasus, larynx.

[12]  T. Hibi,et al.  Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011 , 2012, Modern rheumatology.

[13]  A. Hartmann,et al.  Numerous IgG4-positive plasma cells are ubiquitous in diverse localised non-specific chronic inflammatory conditions and need to be distinguished from IgG4-related systemic disorders , 2011, Journal of Clinical Pathology.

[14]  Luke Barron,et al.  Macrophages: Master Regulators of Inflammation and Fibrosis , 2010, Seminars in liver disease.

[15]  H. Umehara,et al.  IgG4-related Diseases Including Mikulicz’s Disease and Sclerosing Pancreatitis: Diagnostic Insights , 2010, The Journal of Rheumatology.

[16]  K. Ichimura,et al.  IgG4-producing marginal zone B-cell lymphoma , 2008, International journal of hematology.

[17]  T. Wynn.  Fibrotic disease and the TH1/TH2 paradigm , 2004, Nature Reviews Immunology.

[18]  J. Vikse,et al.  IgG 4-related disease , 2018 .

[19]  T. Sumida,et al.  Preferential M2 macrophages contribute to fibrosis in IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz's disease. , 2015, Clinical immunology.

[20]  K. Okazaki,et al.  Comprehensive Diagnostic Criteria for IgG4-Related Disease , 2014 .

[21]  T. Wynn.  Fibrotic disease and the T(H)1/T(H)2 paradigm. , 2004, Nature reviews. Immunology.