Paratesticular fibrous pseudotumor: A new entity of IgG4-related disease?

Yi Che ChangChien, I. Kovács, Zoltán Hargitai, László Magyar

Research output: Article

Abstract

Introduction. Paratesticular fibrous pseudotumor (PFP) represents a benign tumor-like lesion confined to intrascrotal, paratesticular areas. Due to its rarity, only less than 200 cases have been reported to date, of which both pathogenesis and clinical management are little understood. Recently, PFP has been postulated to be among the spectrum of so-called immunoglobulin G4-related diseases (IgG4-RD). Here we describe a case of PFP focusing on the clinical, morphological features and the utility of immunohistochemistry to support the theory that PFP might be a potential member of IgG4-RD family. Case presentation. A 41-year-old man presented with a slowly growing, right intrascrotal mass An MRI scan revealed a diffuse-proliferative nodular mass around the paratesticular area. The patient underwent right orchiectomy and a diffuse multinodular tumor with testicular compression was discovered without intratesticular infiltration. Postoperatively, the patient has been well for 2 years up to the recent follow up. On histological examination, the lesion consisted of hyalinized fibrotic tissue with storiform patterns. There were scattered germinal centers; lymphocytic vasculitis was also noted. The immunoglobulin G4 staining showed infiltration of positive plasma cells with highest count 52 per high-power field, whereas the mixed Kappa and Lambda immunoglobulin light chain expression indicated the polyclonality of the plasma cell population. Conclusions. The morphological and immunohistochemical features in our case support the theory of PFP being part of IgG4-RD. Familiarity to this tumor-like lesion is crucial, since it may respond to corticosteroid therapy, which may save patients from more aggressive surgical procedures.

Original languageEnglish
Pages (from-to)381-385
Number of pages5
JournalAnnals of Clinical and Laboratory Science
Volume48
Issue number3
Publication statusPublished - máj. 1 2018

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Immunoglobulins
Immunoglobulin G
Tumors
Plasma Cells
Infiltration
Immunoglobulin lambda-Chains
Immunoglobulin kappa-Chains
Plasmas
Germinal Center
Orchiectomy
Testicular Neoplasms
Patient Rights
Vasculitis
Neoplasms
Adrenal Cortex Hormones
Immunohistochemistry
Cells
Magnetic Resonance Imaging
Tissue
Staining and Labeling

ASJC Scopus subject areas

  • Microbiology
  • Immunology and Allergy
  • Pathology and Forensic Medicine
  • Immunology
  • Molecular Biology
  • Hematology
  • Clinical Biochemistry
  • Medical Laboratory Technology

Cite this

Paratesticular fibrous pseudotumor : A new entity of IgG4-related disease? / ChangChien, Yi Che; Kovács, I.; Hargitai, Zoltán; Magyar, László.

In: Annals of Clinical and Laboratory Science, Vol. 48, No. 3, 01.05.2018, p. 381-385.

Research output: Article

ChangChien, Yi Che ; Kovács, I. ; Hargitai, Zoltán ; Magyar, László. / Paratesticular fibrous pseudotumor : A new entity of IgG4-related disease?. In: Annals of Clinical and Laboratory Science. 2018 ; Vol. 48, No. 3. pp. 381-385.
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