An unusual cause of pulmonary outflow obstruction: IgG4 deposition disease-MRI observations
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Intraluminal filling defects in the right ventricular outflow (RVOT) are often due to a thrombus or occasionally due to rare lesions like sarcoma arising from pulmonary arteries . Deposition disease is a very rare cause for a thrombus like intra-cardiac luminal defect. IgG4 deposition diseases occasionally present with focal deposition of immunoglobulin deposits at various organs, including the heart . MRI imaging features in the specific clinical contest may provide clue to this rare phenomenon. It is important to recognise this uncommon entity, in view of the widely differing management options.
36-year-old male presented with exertional dyspnoea and progressive loss of weight of 16 kg, over the last 1 year. He had no history of fever or any chronic illness. His physical examination was unremarkable. On echocardiography, he was found to have a filling defect in RVOT, at the level of pulmonary valve. His lab investigations revealed following parameters:...
Authors would like to thank the support of pathology departments of Narayana Health and PGIMER Chandigarh, for confirming the final diagnosis of the pathology material. Our since thanks to Dr Chinnaswamy Reddy for surgical details and Chairman of Narayana Health Dr. Devi Shetty for his guidance and support.
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Conflict of interest
There is no conflict of interest regarding the submitted work.