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IgG4-related disease in the head and neck.
Semin Diagn Pathol. 2012 Nov; 29(4):235-44.SD

Abstract

Lymphoid infiltrates are relatively common in the ocular adnexa and the salivary glands. They are of a variety of types and include both reactive processes and lymphomas. Within the ocular adnexa in years past, lymphoid proliferations were classified as inflammatory pseudotumor, reactive lymphoid hyperplasia, atypical lymphoid hyperplasia, and lymphoma. With improvements in diagnostic techniques and with advances in lymphoma subclassification, it became clear that many of the dense lymphoid infiltrates, including cases classified as lymphoma and likely some classified as atypical lymphoid hyperplasia, represented low-grade B-cell lymphomas, the most common of which by far were extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) lymphomas. Ocular adnexal inflammatory pseudotumor, reactive lymphoid hyperplasia, and chronic sclerosing sialadenitis were recognized, but the focus in diagnosis had been on avoiding misdiagnosis as a neoplastic process and in planning appropriate therapy. Recently, it has become clear that many cases of these reactive processes fall into the spectrum of immunoglobulin G4 (IgG4)-related disease, offering new insight into the pathogenesis of inflammatory lesions occurring in the ocular adnexa and the salivary glands. The majority of entities previously classified as chronic sclerosing sialadenitis, Mikulicz disease, orbital pseudolymphoma, and eosinophilic angiocentric fibrosis are now considered a part of the IgG4-related disease spectrum. In this review, we discuss the histologic and immunohistochemical features of IgG4-related disease of the head and neck and provide guidance for distinguishing this disease from its many mimics.

Authors+Show Affiliations

James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, Boston, Massachusetts, USA. jferry@partners.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23068303

Citation

Ferry, Judith A., and Vikram Deshpande. "IgG4-related Disease in the Head and Neck." Seminars in Diagnostic Pathology, vol. 29, no. 4, 2012, pp. 235-44.
Ferry JA, Deshpande V. IgG4-related disease in the head and neck. Semin Diagn Pathol. 2012;29(4):235-44.
Ferry, J. A., & Deshpande, V. (2012). IgG4-related disease in the head and neck. Seminars in Diagnostic Pathology, 29(4), 235-44. https://doi.org/10.1053/j.semdp.2012.07.008
Ferry JA, Deshpande V. IgG4-related Disease in the Head and Neck. Semin Diagn Pathol. 2012;29(4):235-44. PubMed PMID: 23068303.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - IgG4-related disease in the head and neck. AU - Ferry,Judith A, AU - Deshpande,Vikram, PY - 2012/10/17/entrez PY - 2012/10/17/pubmed PY - 2012/12/10/medline SP - 235 EP - 44 JF - Seminars in diagnostic pathology JO - Semin Diagn Pathol VL - 29 IS - 4 N2 - Lymphoid infiltrates are relatively common in the ocular adnexa and the salivary glands. They are of a variety of types and include both reactive processes and lymphomas. Within the ocular adnexa in years past, lymphoid proliferations were classified as inflammatory pseudotumor, reactive lymphoid hyperplasia, atypical lymphoid hyperplasia, and lymphoma. With improvements in diagnostic techniques and with advances in lymphoma subclassification, it became clear that many of the dense lymphoid infiltrates, including cases classified as lymphoma and likely some classified as atypical lymphoid hyperplasia, represented low-grade B-cell lymphomas, the most common of which by far were extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) lymphomas. Ocular adnexal inflammatory pseudotumor, reactive lymphoid hyperplasia, and chronic sclerosing sialadenitis were recognized, but the focus in diagnosis had been on avoiding misdiagnosis as a neoplastic process and in planning appropriate therapy. Recently, it has become clear that many cases of these reactive processes fall into the spectrum of immunoglobulin G4 (IgG4)-related disease, offering new insight into the pathogenesis of inflammatory lesions occurring in the ocular adnexa and the salivary glands. The majority of entities previously classified as chronic sclerosing sialadenitis, Mikulicz disease, orbital pseudolymphoma, and eosinophilic angiocentric fibrosis are now considered a part of the IgG4-related disease spectrum. In this review, we discuss the histologic and immunohistochemical features of IgG4-related disease of the head and neck and provide guidance for distinguishing this disease from its many mimics. SN - 0740-2570 UR - https://www.unboundmedicine.com/medline/citation/23068303/IgG4_related_disease_in_the_head_and_neck_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0740-2570(12)00050-0 DB - PRIME DP - Unbound Medicine ER -