PMC4120347_01
Excised left lobe of the thyroid gland showing significant enlargement.
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fig1
On operation, the recurrent laryngeal nerve seemed to be damaged due to the mass effect of a stiff thyroid gland (size 5x5.5x8 cm, weight 83 g; Fig. 1), hence only hemithyroidectomy was performed.
Histopathology showing heavy plasmacytic infiltrates and a storiform fibrosis typical of IgG4-related disease of the thyroid gland.
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fig2
Pathology of the excised lobe showed extensive fibrotic process, heavy plasmacytic infiltrates, and storiform fibrosis (Fig. 2), which immunostained strongly for IgG and IgG4 (Figs 3 and 4 respectively) with an IgG4/IgG ratio higher than 80%.
Immunohistochemistry showing plasmacytic cells stained for IgG.
edmcr-2014-140037-g003.jpg
PMC4120347_01_edmcr-2014-140037-g003.jpg
fig3
Pathology of the excised lobe showed extensive fibrotic process, heavy plasmacytic infiltrates, and storiform fibrosis (Fig. 2), which immunostained strongly for IgG and IgG4 (Figs 3 and 4 respectively) with an IgG4/IgG ratio higher than 80%.
Immunohistochemistry showing that most of the IgG-positive plasmacytic cells are also stained for IgG4.
edmcr-2014-140037-g004.jpg
PMC4120347_01_edmcr-2014-140037-g004.jpg
fig4
Pathology of the excised lobe showed extensive fibrotic process, heavy plasmacytic infiltrates, and storiform fibrosis (Fig. 2), which immunostained strongly for IgG and IgG4 (Figs 3 and 4 respectively) with an IgG4/IgG ratio higher than 80%.