PMC5239823_01
(A, B) Plain chest CT on admission showed right pleural effusion and a 10-cm diameter mass in the right lower lobe. (C, D) Plain chest CT after hormonal treatment showed development of pleural effusion and pseudo-tumor.
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C, and laboratory data showed a white blood cell count of 11,900/muL and serum C-reactive protein (CRP) of 12.3 mg/dL. Chest computed tomography (CT) showed right pleural effusion and a 10-cm diameter mass in the right lower lobe and swelling of mediastinal lymph nodes (Fig. 1A and B). At one month after admission, there was marked reduction of pseudo-tumor and right pleural effusion (Fig. 1C and D) on chest CT, and the patient was discharged.
(A) Pathological findings of inflammatory granuloma with infiltration of lymphocytes and plasma cells (red arrow) in trans-bronchial lung biopsy of the pseudo-tumor lesion. (B) Immunohistological images, the deep cells-lgG4-positive plasma cells (>20/HPF) (x400). HPF, high power field.
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The pathological findings from the biopsy showed inflammatory granuloma with infiltration of lymphocytes and plasma cells (Fig. 2A). Immunostaining showed >20 IgG4-positive plasma cells/high-power field (HPF) (Fig. 2B).