[Computed tomograph findings of tissue adjacent to thoracic vertebrae involved by IgG4-related disease].

Objective: To evaluate the computed tomograph (CT) findings of IgG4-related disease (RD) involving soft tissue adjacent to thoracic vertebrae.

Methods: The chest and abdomen CT findings of 22 cases of IgG4-RD proved by orbital pathology and/or laboratory examination were retrospectively reviewed. The CT findings of paravertebral soft tissue in posterior mediastinum and the corresponding follow-up after therapy were primarily observed.

Results: Among them, there were 8 males and 2 females with an average age of 57.6 (42-70) years. CT showed diffuse thickening of soft tissue in thoracic paravertebral space forming a crescent-shaped mass encasing bilateral thoracic vertebrae without abnormal bone change. There was consistent inhomogeneous density of paravertebral adipose tissue adjacent to paravertebral mass lesion with multiple dilated vessels joining azygos vein or vena hemiazygos finally. Other abnormalities were as follows: multiple lymphadenopathy of neck, mediastinum and/or retroperitoneal space (n = 10), interstitial pneumonitis (n = 4), diffuse pancreatic thickening (n = 2) and slightly hypodense soft tissue shadow with a hazy border of retroperitoneal space (n = 8). On follow-up CTs, there was marked relief after regular therapy in 4 cases.

Conclusion: The thoracic paravertebrae space is commonly involved by IgG4-RD. And it occurs frequently in senile males. The characteristic CT feature is diffuse thickening of soft tissue with multiple prominent bands in adjacent thoracic paravertebral space.