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Tertiary lymphoid tissue in early‐stage IgG4-related tubulointerstitial nephritis incidentally detected with a tumor lesion of the ureteropelvic junction: a case report
- Source :
- BMC Nephrology, Vol 22, Iss 1, Pp 1-7 (2021), BMC Nephrology
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background IgG4-related kidney disease causes renal impairment of unknown pathogenesis that may progress to kidney failure. Although ectopic germinal centers contribute to the pathogenesis of the head and neck lesions of IgG4-related disease, the presence of tertiary lymphoid tissue (TLT) containing germinal centers in IgG4-RKD has rarely been reported. Case presentation We report a 72-year-old Japanese man who had IgG4-related tubulointerstitial nephritis (TIN) with TLT formation incidentally detected in a resected kidney with mass lesion of IgG4-related ureteritis in the ureteropelvic junction. During follow-up for past surgical resection of a bladder tumor, renal dysfunction developed and a ureter mass was found in the right ureteropelvic junction, which was treated by nephroureterectomy after chemotherapy. Pathology revealed no malignancy but abundant IgG4-positive cell infiltration, obliterative phlebitis and storiform fibrosis, confirming the diagnosis of IgG4-related ureteritis. In the resected right kidney, lymphoplasmacytes infiltrated the interstitium with focal distribution in the renal subcapsule and around medium vessels without storiform fibrosis, suggesting the very early stage of IgG4-TIN. Lymphocyte aggregates were also detected at these sites and consisted of B, T, and follicular dendritic cells, indicating TLT formation. IgG4-positive cells infiltrated around TLTs. Conclusions Our case suggests that TLT formation is related with the development of IgG4-TIN and our analysis of distribution of TLT have possibility to elucidate IgG4-TIN pathophysiology.
- Subjects :
- Male
0301 basic medicine
Nephrology
Pathology
medicine.medical_specialty
Case Report
Tertiary lymphoid tissue
lcsh:RC870-923
Severity of Illness Index
Lesion
03 medical and health sciences
0302 clinical medicine
Fibrosis
Internal medicine
parasitic diseases
Humans
Medicine
Kidney Pelvis
Aged
030203 arthritis & rheumatology
Incidental Findings
Kidney
Follicular dendritic cells
integumentary system
Ureteral Neoplasms
business.industry
fungi
Germinal center
Ureteritis
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
Kidney Neoplasms
Tertiary Lymphoid Structures
030104 developmental biology
medicine.anatomical_structure
Immunoglobulin G
IgG4-related kidney disease
Nephritis, Interstitial
IgG4-related tubulointerstitial nephritis
medicine.symptom
business
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 14712369
- Volume :
- 22
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Nephrology
- Accession number :
- edsair.doi.dedup.....667d58279ee0ec270b3c948d8c418a21