NDLI: Dermatopathic Lymphadenopathy With Increased IgG4-Positive Plasma Cells

Content Provider	PubMed Central
Author	Nakayama, Shoko Yokote, Taiji Toshikazu, Akioka Miyoshi, Takuji Hirata, Yuji Hiraoka, Nobuya Iwaki, Kazuki Takayama, Ayami Nishiwaki, Uta Masuda, Yuki Hanafusa, Toshiaki Nishimura, Yasuichiro Tsuji, Motomu
Editor	Chen, Zhengshan
Copyright Year	2015
Abstract	Both dermatopathic lymphadenopathy (DL) and immunoglobulin G4-related disease (IgG4-RD) are frequently complicated with allergic diseases. However, the relationship between DL and IgG4-RD is not well known. To clarify this relationship on the basis of clinical and pathological findings, including IgG4-positive (IgG4+) plasma cell infiltration in lymph nodes (LNs) of DL patients, we analyzed LNs of 11 DL patients using immunostaining of IgG, IgG4, forkhead box P3 (FOXP3), transforming growth factor (TGF)-β, interferon (IFN)-γ, and matrix metalloproteinase (MMP)-1, MMP-8, and MMP-13. Toluidine blue staining was also performed to identify mast cells. Of 3 patients with a high ratio of IgG4+/IgG+ cells (>40%) and elevated serum IgG4 levels, 2 developed IgG4-RD, whereas the other patient did not. Of 8 patients with a low ratio of IgG4+/IgG+ cells (<40%) or no infiltration of IgG4+ cells, 5 who could be followed did not develop IgG4-RD. The numbers of mast cells were similar to those of TGF-β-positive cells, and serial sections showed that mast cells possibly produce TGF-β. LNs of DL patients with a high ratio of IgG4+/IgG+ cells had significantly more mast cells and TGF-β-positive cells than those of patients with a low ratio of IgG4+/IgG+ cells or no infiltration of IgG4+ cells. However, no fibrosis was observed in LNs of both groups. IFN-γ was positive in interdigitating dendritic cells, Langerhans cells, and macrophages. MMP-1, MMP-8, or MMP-13 was expressed in macrophages. The lack of fibrosis in LNs may have been due to the production of IFN-γ, MMP-1, MMP-8, or MMP-13. Thus, DL with increased IgG4+ cells seems to be a phenotype of IgG4-RD in LNs.
Related Links	http://dx.doi.org/10.1097/md.0000000000000866
Starting Page	866
File Format	PDF
ISSN	00257974
e-ISSN	15365964
Journal	Medicine
Issue Number	22
Volume Number	94
Language	English
Publisher	Wolters Kluwer Health
Publisher Date	2015-06-01
Access Restriction	Open
Rights Holder	Wolters Kluwer Health
Subject Keyword	Medicine(all) Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Medicine

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