PMC5548681_01
Computed tomography (CT) performed at initial presentation (A-C) and 2 months after the diagnosis of IgG4-related retroperitoneal fibrosis (RF) (D-F). (A-C): CT on admission showed bilateral pleural effusion, a soft tissue mass surrounding the abdominal aorta, and bilateral hydronephrosis caused by sequential thickening of the retroperitoneum with encasement of both ureters. (D-F): Two months after the diagnosis of IgG4-related RF, CT showed improvement of the retroperitoneal lesions.
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An enhanced computed tomography (CT) scan revealed slight bilateral pleural effusion, a soft tissue mass surrounding the abdominal aorta, and bilateral hydronephrosis caused by sequential thickening of the retroperitoneum with encasement of both ureters, which were suspected to indicate RF (Fig. 1A-C). Moreover, radiological findings showed an improvement of the retroperitoneal lesions (Fig. 1D-F).
Computed tomography (CT)-guided percutaneous needle biopsy for muddiness of the retroperitoneal mass lesion (dotted circle). (A) Marking of the biopsy entry site on the CT image in the prone position. (B) CT guided percutaneous fine needle aspiration biopsies using 18G cutting needles.
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We then performed a CT-guided biopsy of the mass lesion surrounding the abdominal aorta (Fig. 2).
Histopathological findings of the retroperitoneal mass lesion. Lymphoplasmacytic infiltration and fibrosis were seen (A) [Hematoxylin and Eosin (H&E) staining, x200]. Storiform fibrosis was also present (B) (H&E staining, x400). IgG immunohistochemical staining revealed that most of the infiltrating plasma cells were positive (x400). IgG4 immunohistochemical staining revealed that more than 50% of the IgG-positive plasma cells were positive for IgG4 (x400).
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Storiform fibrosis was also present (Fig. 3).