Abstract:

Objective To describe the CT findings of IgG4-related diseases in head and neck and analyze their imaging characteristics, in order to improve diagnosis of these diseases. Methods A retrospective cohort study was conducted, including 20 patients with IgG4-related diseases who were diagnosed by histopathology in the Department of Oral and Maxillofacial Surgery of the First Hospital of Shanxi Medical University from September 2019 to December 2021. Demographic information and CT data were collected;sites involved, and lesion characteristics were observed. Results A total of 20 patients were included according to the inclusion and exclusion criteria. There were 14 cases of bilateral submandibular gland involvement, 6 cases of unilateral submandibular gland involvement, 8 cases of bilateral parotid gland involvement, 1 case of unilateral parotid gland involvement, 11 cases of lacrimal gland involvement, and only 3 cases of thyroid involvement. Enlarged lymph nodes around the involved glands or neck were observed in 95%(19 cases) of the patients. Under CT, all patients showed different degrees of diffuse enlargement or substantial mass in the affected salivary glands. No cystic lesions and calcifications were found in all the affected glands under CT scan in cases collected. Lacrimal gland involvement is usually manifested as bilateral symmetrical enlargement with uniform density, and enlargement of extraocular muscles and infraorbital nerve can be seen in some patients. Lymphatic involvement manifested as single or multiple enlarged lymph nodes with clear boundaries, without obvious calcification, necrosis and liquefaction. Thyroid involvement manifested as local hypodensity, irregular shape, and poor boundary with the normal gland. In addition, paranasal glands, nasal mucosa and blood vessels were involved in some patients under CT. Conclusion IgG4-related diseases in head and neck have some physical manifestations under CT scan. Accurate identification and judgment of these manifestations can help clinicians improve the diagnosis of IgG4-related diseases in head and neck and reduce the misdiagnosis rate.

Key words: IgG4-related disease, head and neck, CT, gland