IgG4相关性疾病累及肾盂疑诊肾盂癌1例报告

IgG4-related disease with renal pelvic involvement suspiciously diagnosed as renal pelvis cancer:a case report

本文报道1例IgG4相关性疾病(IgG4-RD)累及肾盂病例。患者体检发现左肾盂占位,CTU、MRI、PET-CT检查均考虑左肾盂癌并多发淋巴结转移,行CT定位左肾孟穿刺活检,结合血清IgG4水平,最终临床确诊IgG4-RD。口服甲泼尼龙治疗后肾盂病灶缩小,IgG4水平下降。IgG4-RD为一种新近认识的可累及全身多器官的纤维炎性疾病,肾孟受累时易误诊为肾盂癌。结合多器官受累可能、血清学检查、影像学特征以及穿刺病理等结果,能够获得正确诊断。本病对糖皮质激素治疗反应良好,但易复发。

Here we report a case of IgG4-related disease(IgG4-RD)involving the renal pelvis.A left renal pelvic mass was found on a patient during medical examination.The imaging examinations of CT urography,MRI and PET-CT all suggested renal pelvic cancer with multiple lymph node metastasis.The CTguided biopsy of left renal pelvis was performed.Combining the pathological results and the serum IgG4 level,the IgG4-RD was finally clinically diagnosed.After oral methylprednisolone treatment,the volume of renal pelvic lesion reduced and the level of IgG4 decreased.IgG4-RD is a newly recognized fibroinflammatory condition which may affect multiple organs.It is easy to be misdiagnosed as renal pelvis cancer when the renal pelvis is involved.Combing the tendency of multiple organ involvement,the serological test,the imaging features and the pathological characteristics,the correct diagnosis can be made.This disease responds well to glucocorticoid treatment,but the relapse is common.