Increased number of IgG4-positive plasma cells in chronic rhinosinusitis

Abstract

Conclusion: High levels of IgG4-positive plasma cells were observed in tissue samples from ∼30% of patients with chronic rhinosinusitis who satisfied the comprehensive diagnostic criteria for IgG4-related disease. Detection of increased numbers of IgG4-positive plasma cells in the nasal cavity or paranasal sinuses might not be sufficient to make a diagnosis of IgG4-related rhinosinusitis, and a comprehensive evaluation is required.

Objectives: This study aimed to clarify the clinicopathological characteristics of IgG4-positive plasma cells in patients with chronic rhinosinusitis.

Method: This study examined nasal mucosal specimens from 35 patients and assigned them to high-IgG4 and low-IgG4 groups based on infiltration of IgG4-positive plasma cells. It compared the pathological characteristics of the two groups, including the presence of fibrosis, phlebitis, hyperplasia of the nasal glands and infiltration of inflammatory cells.

Results: No cases of chronic rhinosinusitis showed storiform fibrosis or obliterative phlebitis. The mean number of IgG4-positive plasma cells in samples from all patients was 29.8 ± 40.3/high-power field. Eleven of the 35 cases (31.4%) were classified as high-IgG4. Hyperplasia of the nasal glands was observed significantly more frequently in the high-IgG4 group than in the low-IgG4 group (p = .03).

Keywords:

• Immunoglobulin G
• IgG4-related disease
• paranasal sinus
• rhinitis
• nasal mucosa

Acknowledgments

The authors thank Ms Masako Akiyama of the University Research Administrator Office, Tokyo Medical and Dental University, for her assistance in the statistical analysis, and Ms Akemi Suzuki and Mr Yuuki Sekijima, Department of Pathology, Tokyo Metropolitan Geriatric Hospital, for their technical assistance.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.