Immunoglobulin G4-Related Disease Presenting as an Obstructing Tracheal Mass: Consideration of Surgical Indications Edward M. Kobraei, MD, Tae H. Song,

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Presentation transcript:

Immunoglobulin G4-Related Disease Presenting as an Obstructing Tracheal Mass: Consideration of Surgical Indications Edward M. Kobraei, MD, Tae H. Song, MD, Douglas J. Mathisen, MD, Vikram Deshpande, MD, Eugene J. Mark, MD The Annals of Thoracic Surgery Volume 96, Issue 4, Pages e91-e93 (October 2013) DOI: 10.1016/j.athoracsur.2013.04.120 Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Imaging of the tracheal lesion. Preoperative 3-dimensional reconstructed bronchoscopic view of the lesion from (A) high in the trachea and (B) just above the lesion around the level of the carina. (C) A coronal computed tomography image reveals partially obstructive lesion just superior to the carina. The Annals of Thoracic Surgery 2013 96, e91-e93DOI: (10.1016/j.athoracsur.2013.04.120) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Low magnification hematoxylin and eosin stain demonstrates prominent lymphoplasmacytic infiltrate in tracheal mass (original magnification ×5). (B) Lesion shown in a high-magnification view (original magnification ×40). The Annals of Thoracic Surgery 2013 96, e91-e93DOI: (10.1016/j.athoracsur.2013.04.120) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Low-magnification hematoxylin and eosin stain of tracheal lesion demonstrates dense cellular infiltrate with an irregular whorled pattern of fibrosis that is characteristic of immunoglobulin G4-related disease (original magnification ×10). (B) High magnification of panel A shows dense collagen and storiform fibrosis (original magnification ×20). The Annals of Thoracic Surgery 2013 96, e91-e93DOI: (10.1016/j.athoracsur.2013.04.120) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Immunohistochemical stain for immunoglobulin G4 demonstrates a diffuse and fairly dense infiltrate of plasma cells positive for immunoglobulin G4 (original magnification ×10). The Annals of Thoracic Surgery 2013 96, e91-e93DOI: (10.1016/j.athoracsur.2013.04.120) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions