IgG4-related small-sized occlusive vasculitis in Mikulicz's disease

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IgG4-related small-sized occlusive vasculitis in Mikulicz's disease Kuniyasu Ikeoka, MD, PhD, Tetsuya Watanabe, MD, PhD, Toshika Ohkawa, MD, PhD, Takashi Tsuzuki, MD, Yoshihiko Ikeda, MD, PhD, Masashi Takeda, MD, PhD, Shiro Hoshida, MD, PhD Journal of Vascular Surgery Cases and Innovative Techniques Volume 5, Issue 3, Pages 289-292 (September 2019) DOI: 10.1016/j.jvscit.2019.03.019 Copyright © 2019 The Authors Terms and Conditions

Fig 1 A, Upper extremity disease was due to occlusion of ulnar artery and superficial palmar arch (computed tomography angiography). B, Branch atheromatous type of cerebral infarction in the left corona radiata area was diagnosed using brain magnetic resonance imaging. C, The left middle cerebral artery was occluded in the magnetic resonance angiography (white arrow). D, A stenosis in the parietal branch of superficial temporal artery was manifested in catheter angiography (white arrowhead). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 289-292DOI: (10.1016/j.jvscit.2019.03.019) Copyright © 2019 The Authors Terms and Conditions

Fig 2 A, The blood vessels of the superficial temporal artery had severe stenosis owing to the intimal hyperplasia with smooth muscle cell proliferation (hematoxylin and eosin staining, ×100). B, Infiltration of plasma cells with eosinophils was observed in the outer layer of vascular hyperplasia (hematoxylin and eosin staining, ×400). C, Eosinophil infiltration was demonstrated using major basic protein staining (staining for major basic protein, ×200). D, Increased IgG4-positive cells were observed in immunohistochemical staining for IgG4 (staining for IgG4, ×400). Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 289-292DOI: (10.1016/j.jvscit.2019.03.019) Copyright © 2019 The Authors Terms and Conditions