PSEUDOTUMOR RENAL RELACIONADO CON IGG4: REPORTE DE CASO
DOI:
https://doi.org/10.56238/levv16n53-056Palabras clave:
Enfermedad Relacionada con IgG4, Pseudotumor Renal, Nefritis Tubulointersticial, Inmunohistoquímica, Diagnóstico DiferencialResumen
La enfermedad relacionada con la inmunoglobulina G4 (IgG4-RD) es una afección inflamatoria sistémica caracterizada por un denso infiltrado linfoplasmocítico, fibrosis y flebitis obliterante. La afectación renal es poco común y puede simular neoplasias, lo que genera confusión diagnóstica y tratamientos invasivos innecesarios. El presente informe se refiere a un paciente con un tumor renal en el lado izquierdo, identificado en exámenes de imagen de rutina. Los hallazgos radiológicos sugirieron angiomiolipoma y el paciente fue sometido a nefrectomía radical. El examen histopatológico reveló fibrosis colágena, áreas de degeneración mixoide y denso infiltrado linfoplasmocitario, con prominentes agregados linfoides. La inmunohistoquímica demostró más de 30 células plasmáticas positivas para IgG4 por campo de alta potencia y una relación IgG4/IgG de aproximadamente 80 %, lo que confirma el diagnóstico de nefritis tubuloinstersticial asociada a IgG4, con formación de pseudotumor. Este caso resalta los desafíos diagnósticos de la IgG4-RD renal, especialmente cuando se presenta como un pseudotumor solitario, ya que los hallazgos radiológicos inespecíficos pueden simular tumores malignos, sometiendo a los pacientes a una terapia quirúrgica radical evitable.
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Referencias
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