2014-03-06
Immunoglobulin G4-related prostatitis: A case-control study focusing on clinical and pathologic characteristics
Publication
Publication
Urology , Volume 83 - Issue 3 p. 521- 526
OBJECTIVE To evaluate the occurrence and histopathologic characteristics of immunoglobulin G4 (IgG4)-
related prostatic involvement in patients diagnosed with autoimmune pancreatitis.
METHODS Nine cases of IgG4-related prostatitis were identified among 117 men in the autoimmune
pancreatitis and IgG4-associated cholangitis patient databases in 2 tertiary hospitals. Clinical
information was retrieved, and available prostatic tissue samples and 18 prostatitis control samples
were evaluated for characteristic IgG4-related disease (IgG4-RD) features: maximum number of
IgG4-positive cells per high-power field; dense lymphoplasmacytic infiltrate; fibrosis, arranged at
least focally in a storiform pattern; phlebitis with or without obliteration of the lumen; and
increased number of eosinophils.
RESULTS The aspecific sign of urine retention was commonly present in IgG4-RD patients with prostatic
involvement. In these patients with IgG4-related prostatitis, the median number of IgG4-positive
cells in prostatic tissue was 150 (interquartile range, 20-150) per high-power field compared with
a median of 3 (interquartile range, 1-11) in control patients (P ¼ .008). Dense lymphoplasmacytic
infiltrate was observed in most (86% in cases and 72% in control patients) tissue samples
independent of the underlying cause of prostatitis. Fibrosis in at least a focally storiform pattern
was seen rarely in both groups, and (obliterative) phlebitis was absent in all patients. Furthermore,
eosinophil numbers were more often elevated in patients with IgG4-RD compared with controls
(P <.001). In 2 cases, amelioration of the prostatitis symptoms on corticosteroid treatment was
documented.
CONCLUSION Prostatic involvement might not be rare in patients with pancreatic or biliary IgG4-RD.
Clinicians should consider this disease entity in patients with IgG4-RD and prostatic
symptoms
Additional Metadata | |
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doi.org/10.1016/j.urology.2013.10.052, hdl.handle.net/1765/54400 | |
Urology | |
Organisation | Department of Pathology |
Buijs, J., Maillette De Buy Wenniger, L., Leenders, G., Verheij, J., van Onna, I., Hansen, B., … van Buuren, H. (2014). Immunoglobulin G4-related prostatitis: A case-control study focusing on clinical and pathologic characteristics. Urology, 83(3), 521–526. doi:10.1016/j.urology.2013.10.052 |