Immunoglobulin G4-Related Disease in the Diaphragm: A Case Report

• Published in: Journal of the Korean Society of Radiology Vol. 85; no. 5; pp. 954 - 959
• Main Authors: Kim, Jin Woo, Kim, Taehwa, Kim, Kun-Il, Jeong, Yeon Joo, Kim, Dohyung, Shin, Dong Hoon, Kim, Yun Seong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.09.2024; 대한영상의학회
• Subjects: case report; computed tomography; diaphragm; immunoglobulin g4-related disease; Thoracic Imaging; 방사선과학; Computed Tomography; Diaphragm; Immunoglobulin G4-Related Disease; Case Report
• ISSN: 2951-0805; 2951-0805
• DOI: 10.3348/jksr.2024.0042

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated condition characterized by mass-forming inflammation with a sclerosing pattern that can affect nearly any organ. However, involvement of the diaphragm in IgG4-RD is exceptionally rare. We present the case of a 62-year-old male patient with chest radiographic abnormalities. Further investigation with CT revealed an infiltrative mass in the right hemidiaphragm. This mass, composed of engorged feeding vessels, an atypical manifestation of IgG4-RD, was also associated with lymphadenopathy. Surgical excision confirmed the presence of IgG4-positive cell infiltration, solidifying the diagnosis of IgG4-RD. Notably, the patient remained asymptomatic and did not require any treatment postoperatively. This case highlights the uncommon presentation of IgG4-RD as an infiltrative diaphragmatic mass.