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Immunoglobulin G4-Related Kidney Disease: A Comprehensive Pictorial Review of the Imaging Spectrum, Mimickers, and Clinicopathological Characteristics.

Seo N, Kim JH, Byun JH, Lee SS, Kim HJ, Lee MG - Korean J Radiol (2015)

Bottom Line: Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD).However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed.In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

ABSTRACT
Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD). However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed. In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review. Awareness of the broad imaging spectrum of IgG4-KD and differential diagnosis from its mimickers will thus facilitate its early diagnosis and treatment.

No MeSH data available.


Related in: MedlinePlus

74-year-old man with IgG4-KD manifesting as perinephric lesion.Contrast-enhanced arterial phase CT image shows homogeneous, rim-like, soft-tissue mass surrounding both kidneys (arrows). Peri-aortic, soft-tissue lesion, indicating retroperitoneal fibrosis, is also observed (arrowhead). IgG4-KD = immunoglobulin G4-related kidney disease
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Figure 8: 74-year-old man with IgG4-KD manifesting as perinephric lesion.Contrast-enhanced arterial phase CT image shows homogeneous, rim-like, soft-tissue mass surrounding both kidneys (arrows). Peri-aortic, soft-tissue lesion, indicating retroperitoneal fibrosis, is also observed (arrowhead). IgG4-KD = immunoglobulin G4-related kidney disease

Mentions: Renal pelvic or perinephric lesions are much rarer than renal parenchymal lesions. Renal pelvic lesions manifest as diffused wall thickening of the renal pelvis, or as a mildly enhanced, soft-tissue mass encasing the renal pelvis (1219). These lesions can be unilateral (Fig. 6) or bilateral (Fig. 7). Hydronephrosis seldom occurs, unless the ureter is entrapped by accompanying periaortic retroperitoneal fibrosis. In our series, only 1 of 10 patients with renal pelvic lesions had a mild, unilateral hydronephrosis without retroperitoneal fibrosis. Perinephric lesions typically appear as a diffuse, rim-like, soft-tissue mass surrounding the kidneys (Fig. 8) (12). These masses usually exhibit homogeneous and mild enhancement. They can be also unilateral or bilateral.


Immunoglobulin G4-Related Kidney Disease: A Comprehensive Pictorial Review of the Imaging Spectrum, Mimickers, and Clinicopathological Characteristics.

Seo N, Kim JH, Byun JH, Lee SS, Kim HJ, Lee MG - Korean J Radiol (2015)

74-year-old man with IgG4-KD manifesting as perinephric lesion.Contrast-enhanced arterial phase CT image shows homogeneous, rim-like, soft-tissue mass surrounding both kidneys (arrows). Peri-aortic, soft-tissue lesion, indicating retroperitoneal fibrosis, is also observed (arrowhead). IgG4-KD = immunoglobulin G4-related kidney disease
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4559777&req=5

Figure 8: 74-year-old man with IgG4-KD manifesting as perinephric lesion.Contrast-enhanced arterial phase CT image shows homogeneous, rim-like, soft-tissue mass surrounding both kidneys (arrows). Peri-aortic, soft-tissue lesion, indicating retroperitoneal fibrosis, is also observed (arrowhead). IgG4-KD = immunoglobulin G4-related kidney disease
Mentions: Renal pelvic or perinephric lesions are much rarer than renal parenchymal lesions. Renal pelvic lesions manifest as diffused wall thickening of the renal pelvis, or as a mildly enhanced, soft-tissue mass encasing the renal pelvis (1219). These lesions can be unilateral (Fig. 6) or bilateral (Fig. 7). Hydronephrosis seldom occurs, unless the ureter is entrapped by accompanying periaortic retroperitoneal fibrosis. In our series, only 1 of 10 patients with renal pelvic lesions had a mild, unilateral hydronephrosis without retroperitoneal fibrosis. Perinephric lesions typically appear as a diffuse, rim-like, soft-tissue mass surrounding the kidneys (Fig. 8) (12). These masses usually exhibit homogeneous and mild enhancement. They can be also unilateral or bilateral.

Bottom Line: Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD).However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed.In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

ABSTRACT
Immunoglobulin G4 (IgG4)-related kidney disease (IgG4-KD) has recently been demonstrated to be an important part of IgG4-related sclerosing disease (IgG4-SD). However, since IgG4-KD is still relatively unfamiliar to radiologists and physicians as compared to IgG4-SD involving other organs, it could, therefore, be easily missed. In this article, we present a comprehensive pictorial review of IgG4-KD with regards to the imaging spectrum, mimickers, and clinicopathologic characteristics, based on our clinical experience with 48 patients during the past 13 years, as well as a literature review. Awareness of the broad imaging spectrum of IgG4-KD and differential diagnosis from its mimickers will thus facilitate its early diagnosis and treatment.

No MeSH data available.


Related in: MedlinePlus