CT Findings of Upper Urinary Tract Lesions in IgG4-Related Disease: Comparison With Urothelial Carcinoma
| Autor: | Koyu Suzuki, Masato Okada, Jin Yamamura, Taiki Nozaki, Minobu Kamo, Kazunori Hattori, Natsuka Muraishi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Urinary system Urology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Fibrosis medicine Humans Ureteral Diseases Radiology Nuclear Medicine and imaging Ureteral neoplasm Hydronephrosis Aged Retrospective Studies Upper urinary tract Aged 80 and over Carcinoma Transitional Cell Ureteral Neoplasms business.industry General Medicine Middle Aged medicine.disease Kidney Neoplasms 030220 oncology & carcinogenesis Pancreatitis Female Kidney Diseases IgG4-related disease Immunoglobulin G4-Related Disease Tomography X-Ray Computed business Calcification |
| Zdroj: | American Journal of Roentgenology. 215:406-412 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.19.22192 |
| Popis: | OBJECTIVE. IgG4-related disease is characterized by extensive infiltration of IgG4-positive plasma cells and fibrosis in various organs. The objective of this study is to investigate CT findings of IgG4-related lesions involving the upper urinary tract and compare them with those of urothelial carcinomas. MATERIALS AND METHODS. This study reviewed pretreatment CT images of 13 consecutive patients with IgG4-related disease with upper urinary tract lesions and 80 consecutive patients with urothelial carcinomas. The findings assessed were laterality, location, growth pattern, margins, internal structure, presence of calcification and lipid component, enhancement pattern, and extraurinary findings. RESULTS. Bilaterality (p < 0.0001), an extramural growth pattern (p < 0.0001), a greater number of affected segments (p = 0.04), and a gradual dynamic enhancement pattern (p < 0.001) were significantly more frequent in patients with IgG4-related disease. With regard to extraurinary findings, paraaortic fat stranding (p = 0.03), presacral fat stranding (p < 0.001), fat stranding of the pelvic walls (p < 0.001), and aortic involvement (p < 0.001) were seen more frequently in patients with IgG4-related disease; on the other hand, there was no statistically significant difference in terms of frequency of pancreatic involvement. Hydronephrosis and renal involvement were seen more frequently in patients with urothelial carcinoma, although the difference was not statistically significant. CONCLUSION. CT findings suggestive of IgG4-related upper urinary tract lesions in comparison with urothelial carcinoma are bilateral and have a longer urinary tract involvement and exhibit an extramural growth pattern, ill-defined margins, a gradual enhancement pattern, aortic involvement, and fat stranding in the paraaortic, presacral, or pelvic wall areas. |
| Databáze: | OpenAIRE |
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