PSEUDOTUMOR RENAL IGG4-RELACIONADO: RELATO DE CASO
DOI:
https://doi.org/10.56238/levv16n53-056Palavras-chave:
Doença Relacionada à Igg4, Pseudotumor Renal, Nefrite Tubulointersticial, Imuno-Histoquímica, Diagnóstico DiferencialResumo
A doença relacionada à imunoglobulina G4 (IgG4-RD) é uma condição inflamatória sistêmica caracterizada por infiltrado linfoplasmocitário denso, fibrose e flebite obliterativa. O envolvimento renal é incomum e pode mimetizar neoplasias, levando a confusões diagnósticas e tratamentos invasivos desnecessários. O presente relato trata-se de uma paciente com um tumor renal à esquerda, identificado em exames de imagem de rotina. Os achados radiológicos sugeriam angiomiolipoma e a paciente foi submetida à nefrectomia radical. O exame histopatológico revelou fibrose colagênica, áreas de degeneração mixoide e infiltrado linfoplasmocitário denso, com agregados linfoides proeminentes. A imuno-histoquímica demonstrou mais de 30 plasmócitos IgG4 positivos por campo de grande aumento e uma relação IgG4/IgG de aproximadamente 80%, confirmando o diagnóstico de nefrite tubuloinstersticial associada à IgG4, com formação de pseudotumor. Este caso evidencia os desafios diagnósticos da IgG4-RD renal, especialmente quando se apresenta como pseudotumor solitário, já que os achados radiológicos inespecíficos podem simular tumores malignos, submetendo os pacientes à terapia cirúrgica radical evitável.
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