case_images: PMC10691889_01
case_images: The findings of pericardial effusion before drainage and steroid therapy in computed tomography (CT) (a, b).
case_images: CRIC2023-9223342.001.jpg
case_images: PMC10691889_01_CRIC2023-9223342.001.jpg
case_images: fig1
case_images: Computed tomography (CT) revealed a large amount of pericardial effusion, and the patient was admitted (Figure 1).
case_images: Positron emission tomography (PET)/CT images before and after steroid therapy. Abnormal 18F-FDG uptake was found in the pericardium (a) and submandibular gland (c) before treatment. After treatment, 18F-FDG uptake in the pericardium (b) and submandibular gland (d) is diminished.
case_images: CRIC2023-9223342.002.jpg
case_images: PMC10691889_01_CRIC2023-9223342.002.jpg
case_images: fig2
case_images: Positron emission tomography (PET)/CT revealed 18F-fluorodeoxyglucose (18F-FDG) uptake in the pericardium and submandibular gland (Figures 2(a) and 2(c)). Follow-up PET/CT showed disappearance of 18F-FDG uptake in the pericardium and submandibular gland (Figures 2(b) and 2(d)).
case_images: Histological sections of biopsy specimens from the submandibular gland. Lymphocytic and plasma cell infiltration (a (100x), d (200x)). Most of the inflammatory cells were positive for IgG immunohistochemical staining (b (100x), e (200x)). More than 40% of the IgG-positive cells were reactive to IgG4 immunohistochemical staining (c (100x), f (200x)).
case_images: CRIC2023-9223342.003.jpg
case_images: PMC10691889_01_CRIC2023-9223342.003.jpg
case_images: fig3
case_images: Histological and immunohistochemical examination of the biopsy specimen of 18F-FDG accumulated in the submandibular gland showed an infiltration of lymphocytes with IgG4-positive cells (10 per high-power field) and an IgG4-positive/IgG-positive cell ratio of 40% (Figure 3).