Highlighting the importance of early diagnosis in progressive multi-organ involvement of IgG4-related disease: A case report and review of literature

Figure 1 Involvement of the lacrimal gland parotid gland. A: Computed tomography (CT) showing double lacrimal gland swelling on both sides; B: CT showing enlargement of the parotid gland.

Figure 2 Involvement of pancreas and bile duct. Abdominal computed tomography (CT) showed enlargement of the head of the pancreas. A: Plain scan showing the enlargement of the head of pancreas; B: Arterial phase showed a slight homogeneous enlargement; C: Portal phase showed an obvious enlargement of the pancreas; D: CT showed the bile duct stricture.

Figure 3 Involvement of the pituitary gland. Magnetic resonance imaging showed the change of pituitary stalk nodular thickening. A: Coronal view clearly showed pituitary stalk nodular thickening (arrow); B: Sagittal view clearly showed pituitary stalk nodular thickening (arrow); C: Coronal view showing a significantly reduced pituitary stalk (arrow); D: Sagittal view showed a significantly reduced pituitary stalk (arrow).

Figure 4 Involvement of lung and bladder mucosa. A: Chest computed tomography showing interstitial pulmonary lesions (arrows) in the lung; B: Immunohistochemical (IHC) staining of IgG4 showed detectable IgG protein and IgG4-positive cell infiltration in bladder mocosa biopsy (bar = 50 μm).