Other urogenital lesions (testis, paratesticular lesion, bladder, prostate etc.)

Abstract

IgG4-related disease (IgG4-RD) is a recently-described type systemic disease that affects many organs, including the pancreas, bile duct, salivary glands, aorta, retroperitoneum, and lungs. A few reports have described IgG4-RD of the prostate, urinary bladder, testes, and urethra. IgG4-RD is distinguished by common clinicopathological characteristics that extend across all organs involved. These common characteristics include lymphoplasmacytic infiltrate characterized by an abundance of IgG4-positive plasma cells, prominent fibrosis with a storiform pattern, mass forming lesions, and elevated serum IgG4 concentrations. These characteristics have also been observed in IgG4-RD of the prostate, urinary bladder, testes, and urethra. Patients who present with IgG4-RD of these organs may have lower urinary tract syndrome (LUTS), typified by dysuria, urine retention, and perhaps hematuria. However, patients with IgG4-RD affecting these organs can also be asymptomatic. IgG4-RD of the testes, which often presents as a painless mass, has frequently been observed in younger patients, posing a challenge in diagnosis.