Abstract
A postoperative lung cancer patient presented with lymphadenopathy, pleural thickening, and 18F-fluorodeoxyglucose (FDG) uptake on a positron emission tomography-computed tomography (PET-CT) scan. Lung cancer recurrence was initially suspected, but bilateral submandibular masses with 18F-FDG uptake indicated the possibility of a systemic disease, such as Mikulicz's disease. High serum immunoglobulin G4 (IgG4) and IgG4-positive plasma cell infiltration in the submandibular glands led to the diagnosis of IgG4-related disease. After systemic steroid therapy, 18F-FDG uptake decreased in both the submandibular glands and the suspected recurrent lesions.
MeSH terms
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Aged
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Autoimmune Diseases / diagnosis*
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Autoimmune Diseases / drug therapy
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Autoimmune Diseases / immunology
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Diagnosis, Differential
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Fluorodeoxyglucose F18*
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Glucocorticoids / therapeutic use
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Humans
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Immunoglobulin G / immunology*
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Lung Neoplasms / diagnosis*
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Lung Neoplasms / surgery
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Lymphatic Diseases / pathology
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Male
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Mikulicz' Disease / diagnosis
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Multimodal Imaging / methods*
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Neoplasm Recurrence, Local / diagnosis*
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Plasma Cells / pathology
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Pleura / pathology
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Positron-Emission Tomography*
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Prednisolone / therapeutic use
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Submandibular Gland / pathology
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Tomography, X-Ray Computed*
Substances
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Glucocorticoids
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Immunoglobulin G
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Fluorodeoxyglucose F18
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Prednisolone