ID 61292
Author
Uchino, Kaori Department of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
Notohara, Kenji Department of Anatomic Pathology, Kurashiki Central Hospital
Uehara, Takeshi Department of Laboratory Medicine, Shinshu University School of Medicine
Kuraishi, Yasuhiro Department of Gastroenterology, Shinshu University School of Medicine
Itakura, Junya Department of Anatomic Pathology, Kurashiki Central Hospital
Matsukawa, Akihiro Department of Pathology and Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University ORCID Kaken ID publons researchmap
Abstract
The utility of gastric biopsy for diagnosing immunoglobulin (Ig)G4‐related gastrointestinal disease (IgG4‐GID) remains unclear. Bottom‐heavy plasmacytosis (BHP) is a distinct feature of IgG4‐GID. To clarify the feasibility of using gastric biopsies to diagnose BHP in IgG4‐GID, we analyzed the histological features and immunostaining of gastric biopsy specimens from 31 known IgG4‐related disease (IgG4‐RD) patients and we assessed the presence of BHP in 1696 consecutive routine gastric biopsies. Cases with both >10 IgG4‐positive plasma cells per high‐power field and an IgG4/IgG‐positive ratio >40% were defined as IgG4‐high. Ten of the 31 IgG4‐RD patients were concluded to have IgG4‐GID, in which IgG4‐positive plasma cells were notably detected at the deeper part of the mucosa. Six cases displayed BHP whereas the remaining four cases showed transmural infiltration with concomitant Helicobacter pylori‐associated gastritis. In addition to BHP, we identified two unique histologic features for IgG4‐GID: plasmacytic aggregation in the muscularis mucosae and permeative plasmacytic infiltration between fundic glands in the non‐atrophic mucosa. Six of the routine cases (0.35%) displayed BHP, including a case with IgG4‐RD. IgG4‐GID can be suspected by the presence of gastric biopsy specimens with characteristic histological features. Such cases are recommended to undergo further examinations to determine whether IgG4‐RD is present.
Keywords
biopsy
feasibility studies
gastric mucosa
gastritis
IgG4
IgG4‐related disease
immunoglobulin G4
immunohistochemistry
plasma cells
Note
This is the peer reviewed version of the following article: Kaori Uchino et. al. Utility of gastric biopsy in diagnosing IgG4‐related gastrointestinal disease. Pathology International (2020), which has been published in final form at [https://doi.org/10.1111/pin.13059. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
This fulltext is available in Jan. 2022.
Published Date
2020-12-30
Publication Title
Pathology International
Volume
volume71
Issue
issue2
Publisher
Wiley
Start Page
124
End Page
134
ISSN
1320-5463
NCID
AA10984364
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
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author
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DOI
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Related Url
isVersionOf https://doi.org/10.1111/pin.13059