Diffusion restriction in patients with IgG4-related orbital disease
Author: Morsal Askanderi
Base Hospital / Institution: University Medical Center Utrecht
ePoster presentation
Abstract ID: 24-184
Purpose
Diffusion Weighted Imaging (DWI) is widely used to differentiate between orbital lymphoma (OL) and idiopathic orbital inflammation (IOI), whereby diffusion restriction is highly suggestive for OL. To our knowledge, however, there are no studies of diffusion restriction in IgG4-related orbital disease (IgG4-ROD) yet. Therefore, the aim of this study is to investigate the presence of diffusion restriction (DR) in patients with histologically proven IgG4-ROD.
Methods
In this retrospective study, the MRI images of 13 patients with in total 23 IgG4-ROD lesions were reviewed. Special attention was paid to the DWI and apparent diffusion coefficient (ADC) sequences, on the basis of which the presence or absence of DR was determined. In addition, histopathological features were described in 12 biopsies with emphasis on hypercellularity, and were compared to the MRI findings.
Results
Primary outcome: seventy percent (16/23) of the lesions with IgG4-ROD showed DR on the MRI.
Secondary outcome: nine out of 12 biopsies showed both hypercellularity and DR on the MRI. In 3 cases which did not show DR, hypercellularity was not demonstrated either. However, the IgG4+/IgG+plasma cell ratio confirmed the diagnosis IgG4-ROD.
Conclusion
DR is often seen in IgG4-ROD. IgG4-ROD should be included in the differential diagnosis in orbital lesions with DR. Biopsy remains the golden standard. Therefore, specific request for determining IgG4 features in histopathological examination is mandatory.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Rachel | Kalmann | University Medical Center Utrecht |
