Immunoglobulin G4-related chronic rhinosinusitis: a pitfall in the differential diagnosis of granulomatosis with polyangiitis, Rosai-Dorfman disease, and fungal rhinosinusitis
机构：[1]Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China首都医科大学附属北京同仁医院医技科室病理科[2]Beijing Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, Beijing, China首都医科大学附属北京同仁医院首都医科大学附属同仁医院[3]Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China临床科室耳鼻咽喉-头颈外科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[4]Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China研究所耳鼻咽喉科研究所首都医科大学附属北京同仁医院首都医科大学附属同仁医院[5]Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China临床科室变态反应科首都医科大学附属北京同仁医院首都医科大学附属同仁医院
Immunoglobulin G4 (IgG4)-related chronic rhinosinusitis (CRS) has recently been proposed to be a new clinical entity of nasal disease, with no consensually agreed criteria for diagnosis. Moreover, the pathological features of IgG4-related CRS often overlap with other sinonasal inflammatory and autoimmune diseases such as granulomatosis with polyangiitis (GPA), Rosai-Dorfman disease (RDD) and fungal rhinosinusitis (FRS). We aimed to explore the specific similarities and differences in clinicopathologic features between IgG4-related CRS, and GPA, RDD and FRS, in order that these conditions can be diagnosed more accurately. Biopsy specimens collected from nasal mucosa of 20 IgG4-related CRS, 10 GPA, 10 RDD and 10 FRS patients were assessed by hematoxylin and eosin staining and immunohistochemical techniques for specific histochemical differences. The number of IgG4-positive plasma cells/high-power fields (HPF) in biopsies from IgG4-related CRS patients (mean = 79.6 +/- 51.59; range = 15/HPF to 230/HPF) was significantly higher than in biopsies from GPA (mean = 13 +/- 9.428; P<.0001) and RDD (mean = 12.5 +/- 8.267; P<.0001) patients, but not from FRS (mean = 47.4 +/- 26.48; P>.05) patients. Similarly, the ratio of IgG4/IgG-positive plasmacytes was >40% in 90% (18/20) of IgG4-related CRS patients, compared to >40% in 10% (1/10) of GPA patients, 20% (2/10) of RDD patients and 20% (2/10) of FRS patients. The sinonasal diseases GPA, RDD and FRS might present with similar histopathologic features such as the increased numbers of plasma cells and fibrosis, which are characteristic of IgG4-related CRS. A comprehensive consideration combining the clinical signs and symptoms with a histopathological assessment of IgG4-positive plasma cells may provide accurate diagnoses of these conditions. (C) 2017 Elsevier Inc. All rights reserved.
基金：
National Key R&D Program of China (2016YFC20160905200), Changjiang Scholars and Innovative
Research Team (IRT13082), the National Natural Science Foundation of China (81420108009, 81570895, 81400444, 81470678 and 81630023), the Special Fund of
CapitalHealthDevelopment (2011-1017-06,2011-1017-02), the Special Fund of Sanitation Elite Reconstruction of Beijing (2009-2-007), BeijingHealth Bureau Program
for High Level Talents (2011-3-043), Beijing Municipal Administration of Hospitals' Mission Plan (SML20150203) and Capital Citizenry Health Program
(z161100000116062).
第一作者机构：[1]Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China[2]Beijing Key Laboratory of Head and Neck Molecular Pathological Diagnosis, Beijing TongRen Hospital, Capital Medical University, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[3]Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China[4]Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China[5]Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China[*1]Department of Otolaryngology - Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No.1, Dongjiaominxiang, DongCheng District, Beijing 100730, PR China.[*2]Beijing Institute of Otolaryngology, No. 17, HouGouHuTong, DongCheng District, Beijing, 100005, PR China.
推荐引用方式(GB/T 7714)：
Piao Yingshi,Zhang Yuan,Yue Changli,et al.Immunoglobulin G4-related chronic rhinosinusitis: a pitfall in the differential diagnosis of granulomatosis with polyangiitis, Rosai-Dorfman disease, and fungal rhinosinusitis[J].HUMAN PATHOLOGY.2018,73:82-88.doi:10.1016/j.humpath.2017.12.011.
APA：
Piao, Yingshi,Zhang, Yuan,Yue, Changli,Wang, Chengshuo&Zhang, Luo.(2018).Immunoglobulin G4-related chronic rhinosinusitis: a pitfall in the differential diagnosis of granulomatosis with polyangiitis, Rosai-Dorfman disease, and fungal rhinosinusitis.HUMAN PATHOLOGY,73,
MLA：
Piao, Yingshi,et al."Immunoglobulin G4-related chronic rhinosinusitis: a pitfall in the differential diagnosis of granulomatosis with polyangiitis, Rosai-Dorfman disease, and fungal rhinosinusitis".HUMAN PATHOLOGY 73.(2018):82-88
