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Tumor Discovery

CASE REPORT
A rare clinical observation of ureteral

IgG4-related disease in urological practice:
A case report

1,3
1,2
Ekaterina Anikanova *, Daniel Yagudaev , Konstantin Firsov ,
1,3
4,5
Nina Kalyagina *, and Arina Plotnikova 5
1 Department of Urology and Oncology, Central Clinical Hospital “Russian Railways-Medicine,”
Moscow, Russia
2 Department of Oncology and Radiology, Medical Faculty, A.I. Evdokimov Moscow State University
of Medicine and Dentistry, Moscow, Russia
3 Department of Endoscopic Urology, Faculty of Further Education, the Peoples’ Friendship University
of Russia, Moscow, Russia
4 Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia
5 Engineering Physics Institute of Biomedicine, National Research Nuclear University MEPhI, Moscow,
Russia

Abstract

IgG4-related disease (IgG4-RD) is a systemic immune-dependent pathology marked
by infiltration of lymphocytes and plasma cells expressing IgG4 in affected tissues,
leading to phlebitis and fibrosclerosis. In urological practice, diagnosing IgG4-RD of
*Corresponding authors: the ureter, which may resemble a malignant tumor, presents challenges. We present
Ekaterina Anikanova
(Anikanova1801@gmail.com) a unique case: a 64-year-old patient (Patient P.) experienced left lumbar discomfort
Nina Kalyagina and a 4 kg weight loss over 2 months. A computed tomography scan revealed a
(Nina.Kalyagina@gmail.com) 111 mm tumor obstructing the left ureter, causing hydronephrosis and regional
Citation: Anikanova E, lymphadenopathy. Suspecting ureteral urothelial cancer, the patient underwent
Yagudaev D, Firsov K, et al., a left nephroureterectomy with lymphadenectomy. Microscopic analysis revealed
2023, A rare clinical observation
of ureteral IgG4-related disease in fibrosis and inflammation infiltration (lymphocytes, plasma cells, and eosinophils) in
urological practice: A case report. the ureter wall, with no evidence of tumor growth. Immunohistochemistry confirmed
Tumor Discov, 2(3): 1766. IgG4-positive plasma cells. Serum IgG4 rose to 149 mg/dL. Morphological findings led
https://doi.org/10.36922/td.1766
to a diagnosis of IgG4-RD of the ureter. Clinically, it is crucial to recognize IgG4-RD in
Received: September 5, 2023 ureteral neoplasms for early detection, to prevent unnecessary surgical intervention.
Accepted: November 13, 2023
Published Online: November 24,
2023
Keywords: IgG4-related diseases; IgG4; Ureter; Pseudotumor inflammation; Urothelial
Copyright: © 2023 Author(s). cancer
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. IgG4-related disease (IgG4-RD) is a systemic immune-mediated pathology characterized
Publisher’s Note: AccScience by diffuse or focal infiltration of affected tissues by lymphocytes and plasma cells expressing
Publishing remains neutral with IgG4, with the absence of neutrophils (a moderate amount of eosinophils may be present).
regard to jurisdictional claims in
published maps and institutional Subsequently, the condition leads to the development of phlebitis and fibrosclerosis,
affiliations. accompanied by an increase in IgG4 content in serum, serving as a laboratory sign [1-3] .

Volume 2 Issue 3 (2023) 1 https://doi.org/10.36922/td.1766