IgG4相关腹膜后纤维化的临床表现与影像特点分析

Analysis of Clinical Manifestations and Imaging Features of IgG4-related Retroperitoneal Fibrosis

目的探讨IgG4相关腹膜后纤维化的临床表现与影像特点。方法回顾性分析该院自2014年6月—2019年12月收治的40例IgG4相关腹膜后纤维化患者的临床资料,分析临床表现、实验室检查及影像学检查等,分析其临床表现及影响特点。结果 IgG4相关腹膜后纤维化的临床表现有腰痛占60.00%、淋巴结肿大占40.00%、腹痛占30.00%、浮肿占27.50%等;患者均行增强CT、MRI等检查,显示患者腹膜后、主动脉周围软组织肿块,病理显示大量淋巴细胞浸润伴随淋巴滤泡,纤维组织增生。通过免疫组织化学染色发现IgG4阳性浆细胞>10/高倍视野,IgG4/IgG>30%。结论 IgG4相关腹膜后纤维化的症状缺乏特异性,容易误诊或者漏诊,应提高此病的鉴别。

Objective To investigate the clinical manifestations and imaging features of IgG4-related retroperitoneal fibrosis. Methods The clinical data of 40 IgG4-related retroperitoneal fibrosis patients admitted to the hospital from June2014 to December 2019 were retrospectively analyzed, clinical manifestations, laboratory examinations and imaging examinations were analyzed, and their clinical manifestations and effects were analyzed. Results The clinical manifestations of IgG4-related retroperitoneal fibrosis included low back pain accounted for 60.00%, lymph node enlargement accounted for 40.00%, abdominal pain accounted for 30.00%, edema accounted for 27.50%, etc;all patients underwent enhanced CT,MRI and other examinations. A mass of soft tissue around the artery pathology showed a large number of lymphocyte infiltration accompanied by lymphoid follicles and fibrous tissue proliferation. Immunohistochemical staining revealed that IgG4-positive plasma cells were >10/high power field, and IgG4/IgG was >30%. Conclusion The symptoms of IgG4-related retroperitoneal fibrosis lack specificity and are easy to be misdiagnosed or missed. The identification of this disease should be improved.