case_images: PMC10558095_01
case_images: Imaging and histological findings of the patient. (A) 18F-Fluorodeoxyglucose (18F-FDG) PET-CT showing accumulation of 18F-FDG in the lacrimal glands, salivary glands, lymph nodes, pancreas, prostate and bilateral kidneys. (B) Biopsy of the right submandibular grand showing infiltration of IgG4-positive plasma cells. (C) Biopsy of the right kidney showing storiform fibrosis (Periodic Acid Methenamine Silver staining). (D) Biopsy of the right kidney showing obliterative phlebitis (Elastica Masson staining). (E) Biopsy of the right kidney showing infiltration of eosinophils in the interstitium of the kidney (Haematoxylin and Eosin staining)
case_images: rkad078f1.jpg
case_images: PMC10558095_01_rkad078f1.jpg
case_images: rkad078-F1
case_images: The patient's bone marrow biopsy results did not indicate haematologic disease, and chromosomal abnormality was not found. 18F-Fluorodeoxyglucose (18F-FDG) PET-CT revealed 18F-FDG accumulation in the lacrimal glands, salivary glands, lymph nodes, pancreas, prostate and bilateral kidneys (Fig. 1A). IgG4 positive (Fig. 1B). In addition, biopsy of the right kidney revealed infiltration of IgG4-positive plasma cells, accompanied by storiform fibrosis and obliterative phlebitis (Fig. 1C, D). Infiltration of eosinophils into the interstitium of the kidney was also observed (Fig. 1E). In addition, the patient experienced anaphylactic shock accompanied by decreased blood pressure (107/90 mmHg), tachypnoea (24 breaths/min), dyspnoea, wheeze on chest auscultation, and cold sweats after meals during the period of scrutiny, despite having no allergic history.