the differential diagnosis of two cases of chronic periaortitis

the differential diagnosis of two cases of chronic periaortitis

;Takao Kato;Eri Minamino;Eisaku Nakane;Shoichi Miyamoto;Toshiaki Izumi;Tetsuya Haruna;Ryuji Nohara;Moriaki Inoko
faṣlnāmah-i pizhūhish/hā-yi rāhburdī-i siyāsat 2013 Vol. 2013 pp. -
194
kato2013casethe

Abstract

The imaging features of chronic periaortitis resemble those of infected aneurysms. Two illustrative cases of chronic periaortitis, in which the etiologies were caused by IgG4-related disease, are presented. The first case involved a 68-year-old man who presented with vague discomfort in his lower abdomen. The second case was a 42-year-old man who presented with a fever of 38°C and persistent, vague chest discomfort. Both cases demonstrated an increased amount of connective tissue around the aorta in computed tomography images and low intensity in the T2-weighed sequence and high intensity in the diffusion-weighed sequence, suggesting the presence of inflammation, in the magnetic resonance imaging. Negative blood cultures, elevated IgG4 levels, and pathological findings confirmed the diagnosis as chronic periaortitis due to IgG4-related disease. This is a newly recognized syndrome of unknown etiology, characterized by a fibroinflammatory condition, tumefactive lesions, and a dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells. Both cases were successfully treated with corticosteroids. Infected aneurysms need to be carefully differentiated from this syndrome in view of the similar imaging features.

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149606
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10.1155/2013/282067
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