Immunoglobulin G4-positive lymphoplasmacytic infiltration in a sarcoidal eyelid mass

Abstract

A 62-year-old woman presented with a one month history of a hard, nonmobile subcutaneous mass along the right nasojugal fold. Hematological studies showed elevated serum immunoglobulin G4 levels. Histopathological examination of the biopsy sample disclosed immunoglobulin G4-positive lymphoplasmacytic infiltration with a storiform fibrosis, vein occlusion, and epithelioid granulomas with necrosis. Systemic review corresponded to a sarcoidosis. Without treatment, the eyelid mass did not recur six months after the excisional biopsy.

Keywords:

• Epithelioid granuloma
• Immunoglobulin G4
• Sarcoidosis
• Storiform fibrosis
• Vein occlusion

Acknowledgments

The authors wish to acknowledge Dr. Masayuki Yamaji from the Department of Thoracic Surgery, Aichi Medical University, for his advice on radiographic image interpretation.

Ethics approval

This study was approved by the local ethics committee (number: 2015-024) and adhered to the tenets of the 1964 Declaration of Helsinki. The patients gave informed consent prior to inclusion in the study. Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

Conflict of interest

None.