Abstract
A 55-year-old female consulted an internist because of abnormalities on a screening upper gastrointestinal series. It showed an elevated lesion in the lesser curvature and the anterior wall of the stomach. Upper gastrointestinal endoscopy showed an elevated lesion in the upper part of the stomach with no abnormalities of the gastric mucosa. Endoscopic ultrasonography showed that the tumor was a submucosal tumor derived from the muscle layer of the stomach. Computed tomography showed a 4-cm tumor in the anterior wall of the body of the stomach. Therefore, laparoscopic endoscopic cooperative surgery was performed suspecting a gastrointestinal stromal tumor. Histopathological examination showed lymphoplasmacytic infiltration and fibrosis, and immunohistochemistry showed infiltration of IgG4-positive lymphoplasmacytic cells. Probable IgG4-related sclerosing disease of the stomach was diagnosed. This appears to be the first case of probable IgG4-related sclerosing disease presenting as a submucosal tumor of the stomach.
