IgG4-related Periarteritis Successfully Diagnosed by an Alternative Prostate Biopsy

Intern Med. 2019 Aug 15;58(16):2401-2406. doi: 10.2169/internalmedicine.2723-19. Epub 2019 Apr 17.


A 56-year-old man was referred to our facility after developing edema in his right leg. Enhanced computed tomography (CT) revealed a periarterial soft tissue mass surrounding the right iliac artery compressing the iliac vein. His elevated serum IgG4 level indicated IgG4-related disease (IgG4-RD). Both a percutaneous and surgical biopsy of this periarterial lesion proved challenging and were not pursued. A prostate biopsy, however, finally provided a histological diagnosis of IgG4-RD. Oral steroid therapy successfully resolved his leg edema and periarterial lesion. This case illustrates the usefulness of an alternative prostate biopsy for the histological diagnosis of IgG4-RD when approaching the primary affected lesion is difficult.

Keywords: IgG4-related disease; periarteritis; prostate biopsy; prostatitis.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Arteritis / diagnosis*
  • Arteritis / drug therapy*
  • Biopsy / methods*
  • Humans
  • Iliac Artery / diagnostic imaging*
  • Immunoglobulin G / blood*
  • Male
  • Middle Aged
  • Prostatic Neoplasms / diagnosis*
  • Steroids / administration & dosage
  • Steroids / therapeutic use*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome


  • Immunoglobulin G
  • Steroids