PMC8339229_01
(a)Histological examination of left inguinal lymph node revealed numerous lymphoid follicles with active germinal centers. (hematoxylin-eosin [HE] stain; low power view. Bar: 500mum). (b)High power view shows prominent lymphoplasmacytic infiltration in inter-follicular area, but obliterative phlebitis, dense fibrosis, or eosinophilic infiltrations were not apparent (HE stain; bar, 50mum).. Immunohistochemical stains show (c)IgG+ and (d)IgG4+ plasma cell infiltration; IgG4+/IgG + plasma cell ratio was over 40% (bar, 100mum).
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Histological examination of his left inguinal LN revealed prominent lymphoplasmacytic infiltration in the inter-follicular area, but eosinophilic infiltrations were not apparent (Fig. 1a and b). Immunohistochemically, marked IgG4+ plasma cell infiltration was observed and his IgG4+/IgG+ plasma cell ratio was over 40% (Fig. 1c and d).
(a) Histological examination of surgical lung biopsy at right S8 showed dense lymphoplasmacytic accumulations and collagenous fibrosis mainly in the alveolar area adjacent to the peri-lymphatic stromal area (hematoxylin-eosin [HE] stain; low power view; bar: 5000mum. (b)Some areas show dense collagenous fibrosis (HE stain;. bar; 200mum). (c)Focal dense eosinophilic infiltrations (HE stain: high power view; bar: 50mum). (d)Few IgG4+ plasma cells were observed (bar: 100mum).
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S8 showed dense lymphoplasmacytic accumulations, mainly in the alveolar area adjacent to the peri-lymphatic stromal area (Fig. 2 a, b). Some focal dense eosinophilic infiltrations and collagenous fibrosis were also noted (Fig. 2 c, d), but few IgG4+ plasma cells were observed. Serum level of IgG and IgG4 were increased (6858mg/dl and 3140 mg/dl, respectively).