• Ikuko Matsumura, Takeki Mitsui, Kenichi Tahara, Hiroaki Shimizu, Kunio Yanagisawa, Takuma Ishizaki, Hiromi Koiso, Makiko Takizawa, Akihiko Yokohama, Takayuki Saitoh, Junko Hirato, Hirokazu Murakami, Hiroshi Handa, and Norifumi Tsukamoto.
• Department of Hematology, Gunma University Graduate School of Medicine, Japan.
• Intern. Med. 2020 May 1; 59 (9): 1203-1209.

AbstractA 69-year-old man with palpitations and decreased blood pressure was referred. Echocardiography showed a mass in the right atrium and cardiac septum. The serum IgG4 level was 1,450 mg/dL. A biopsy of the cardiac mass showed fibrosis with inflammatory cells and increased IgG4-positive plasma cells and lymphocytes. Flow cytometry and polymerase chain reaction of the immunoglobulin heavy chain did not demonstrate monoclonality. He was diagnosed with IgG4-related disease (IgG4-RD). IgG4-RD with a cardiac mass is rare and it is difficult to distinguish it from malignant lymphoma by a pathological examination alone. We therefore performed a biopsy and analyzed the clonality in order to make an accurate diagnosis of IgG4-RD.

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