2016 Volume 62 Issue 3 Pages 228-231
We describe the case of a 32-year-old man with C-reactive protein (CRP) elevation of unknown origin who was transferred to Juntendo University Hospital on suspicion of systemic viral infection. Whole-body computed tomography (CT) showed enlargement of the para-aortic, common iliac and axillary lymph nodes. Laboratory data showed elevated levels of immunoglobulin (Ig)G4. Axillary lymph node biopsy was performed to investigate suspected IgG4-related disease, revealing marked infiltration of IgG4-positive plasma cells. Various imaging modalities and laboratory tests have recently become available. However, most neoplastic diseases need invasive testing such as biopsy to reach a definitive diagnosis. Clinicians should not hesitate to obtain pathological specimens to definitively diagnose patients with suspected neoplastic disease.