IgG4-related hypophysitis is highly prevalent among cases of histologically confirmed hypophysitis

Bernreuther C, Illies C, Flitsch J, Buchfelder M, Buslei R, Glatzel M, Saeger W (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Brain Pathology Wiley-Blackwell

Book Volume: 27

Pages Range: 839-845

Journal Issue: 6

DOI: 10.1111/bpa.12459

Abstract

IgG4-related disease is an immune-mediated disease with manifestations in most organ systems among them the pituitary gland. To date, few cases of histologically confirmed cases of IgG-related hypophysitis have been reported. The aim of this study was to retrospectively determine the prevalence of IgG4-related hypophysitis among cases previously diagnosed as primary hypophysitis (lymphocytic hypophysitis, granulomatous hypophysitis and hypophysitis not otherwise specified). Histological and immunohistochemical analysis revealed that 12 of 29 cases (41.4%) previously diagnosed as primary hypophysitis fulfilled the criteria for IgG4-related disease and, thus, IgG4-related hypophysitis should always be considered in the differential diagnosis of primary hypophysitis. All cases of IgG4-related hypophysitis showed a dense lymphoplasmacytic infiltrate with more than 10 IgG4-positive cells per high power field and a ratio of IgG4/IgG-positive cells of more than 40%, whereas storiform fibrosis was an inconsistent histological feature and was also seen in few cases of non-IgG-related hypophysitis, thus lacking sensitivity and specificity. Obliterative phlebitis was not seen in any case. Thus, histological criteria defined for IgG4-related disease in other organs should be modified for IgG4-related hypophysitis, accordingly.

Authors with CRIS profile

Michael Buchfelder Lehrstuhl für Neurochirurgie

Involved external institutions

Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Karolinska University Hospital / Karolinska Universitetssjukhuset SE Sweden (SE)

How to cite

APA:

Bernreuther, C., Illies, C., Flitsch, J., Buchfelder, M., Buslei, R., Glatzel, M., & Saeger, W. (2017). IgG4-related hypophysitis is highly prevalent among cases of histologically confirmed hypophysitis. Brain Pathology, 27(6), 839-845. https://doi.org/10.1111/bpa.12459

MLA:

Bernreuther, Christian, et al. "IgG4-related hypophysitis is highly prevalent among cases of histologically confirmed hypophysitis." Brain Pathology 27.6 (2017): 839-845.

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